US COPD Coalition

DHHS Publishes Policy Brief on COPD in Rural America


The Department of Health and Human Services National Advisory Committee on Rural Health and Human Services has published an important policy brief addressing the severe burden of COPD in rural America. Entitled Addressing the Burden of Chronic Obstructive Pulmonary Disease (COPD) in Rural America: Policy Brief and Recommendations, the report discusses the significant disparity when it comes to COPD in rural vs. urban areas. “By geography, COPD significantly affects rural residents as compared to individuals who live in urban centers”, the authors of the report state. “Research findings from a 2018 Johns Hopkins study revealed a higher estimated COPD prevalence among rural, poor communities, suggesting that rural residence and poverty are independent COPD risk factors.”

The report offers three overarching recommendations for lessening the burden of COPD in our rural communities:

  1. The Committee recommends the Secretary and the Department of Health and Human Services undertake a national campaign to educate rural primary care providers and individuals with COPD symptoms about rural-urban disparities in COPD outcomes with an emphasis on the need to do more screening and referral for effective treatments to help manage the disease.
  2. The Committee recommends that prior to the next revaluation of outpatient prospective payment rates, the Department of Health and Human Services consult with experts in pulmonary treatment to refine the definition of rehabilitation services and, in Medicare cost reports, confirm that there is adequate accurate data on this service to be used as a basis for the rate.
  3. The Committee recommends the Secretary work with Congress to expand direct supervision of pulmonary rehabilitation to include physician assistants, nurse practitioners and other primary care providers under general supervision of a physician.

Perhaps most importantly, the report calls on Congress to address the greatest barrier to lowering the burden of COPD…adequate funding. “[U]nlike other chronic diseases, COPD does not explicitly have a home within the broader HHS surveillance and research infrastructure and therefore does not have direct funding lines. Given the high burden of COPD-related outcomes among rural areas, the Committee encourages the Secretary to consider working with Congress to fund the CDC to create a National COPD Control Program …Moreover, the CDC should fund health departments in 50 states, the District of Columbia and Puerto Rico to ensure the availability of and access to guidelines-based medical management and pharmacotherapy for all people with COPD. Furthermore, the CDC should address the intersection of public health and healthcare by funding state programs and national organizations, promoting COPD quality measures, and informing policy makers about the burden of COPD.”

Click on the link below to read the full report.
Rural COPD Report December 2018