When national organizations need experts to speak to the most urgent issues in the field, they turn to Temple Health. That’s why Hernan Alvarado, MBA, RRT, RPFT, Temple University Hospital, Inc.’s Associate Vice President of Respiratory Care and Sleep Diagnostics, was invited to the American Association of Respiratory Care (AARC)’s DC Fly-In event.
“The AARC sends delegates from across the country to its annual Fly-In in Washington, D.C. to speak with legislators and their staff about the hot topics in respiratory care,” Alvarado explains. “I was honored to represent Temple as one of the Pennsylvania delegates, alongside Natalie Napolitano, MPH, RRT-NPS, FAARC from CHOP and Jefferson Mixell, MBA, RRT from Penn State Health.”
One of the most pressing concerns at the Fly-In was virtual pulmonary rehab: an alternative to in-person rehabilitation that was authorized to be covered under Medicare as part of a telemedicine bill passed during the COVID-19 pandemic. But while virtual pulmonary rehab can be a useful option for patients who would otherwise have to travel long—even prohibitive—distances for care, its Medicare cost coverage has since expired. The AARC is advocating for virtual pulmonary rehab to once again be covered, and met with legislators and their staff members to discuss this issue.
“I spoke to Laura M. Guerra, Congressman Dwight Evans’ Legislative Assistant, and invited her and Congressman Evans—who represents Temple University Hospital-Main Campus’ district—to visit us,” Alvarado says. “I discussed our patients and their needs, and how many patients travel long distances to see Gerard J. Criner, MD, FACP, FACCP, Director of the Temple Lung Center, and our team.”
“The Lung Center is looking at a few options for how we might implement virtual pulmonary rehab,” Alvarado continues. “It’s all about what would be most beneficial to our patients. As Temple is the flagship for pulmonary care across the country, and a national leader in lung transplant outcomes, all of the other representatives at the Fly-In wanted to know what we’re doing. They kept asking me, ‘What’s going on at Temple?’”
Advocating for Equitable Access
Another hot topic at the Fly-In was the Supplemental Oxygen Access Reform (SOAR) Act of 2024, which would make it easier for Medicaid beneficiaries to access supplemental oxygen. The SOAR Act would set up a new payment system for non-liquid oxygen, so that most Medicare recipients would be covered under the base payment levels—or, in other words, that supplemental oxygen would be much more affordable. The SOAR Act would also ensure that liquid oxygen would be available to patients for whom it is medically necessary.
“Right now, supplemental oxygen is in the Medicare competitive billing process,” Alvarado explains. “That means the type of oxygen delivery device is usually chosen based on what’s most cost-effective. But that can cause problems for our patients. I was able to tell legislators’ staff about how, if a patient is making a long drive to see us, and they have to bring six large cylinders of non-liquid oxygen in their car just to make it through the drive, they’re basically carrying a bomb with them. But if they were able to bring liquid oxygen, it would be much less dangerous.”
“A lot of times, patients go through four of those six non-liquid cylinders just on the drive down,” Alvarado continues. “They would need four to get back after their visit, but they only have two left. Now, they have a decision to make. Are they calling a delivery company and getting an emergency oxygen drop-off at the hospital? Or am I going to have to get in touch with Regulatory and ask if they can borrow one of Temple’s cylinders? That’s a lot for a patient to deal with—especially when they can’t breathe. But if they could have accessed liquid oxygen—which is a lot smaller, and last a lot longer, and can be replenished at the hospital or doctor’s office—then they’d be in much better shape.”
A National Center of Excellence
While Alvarado won’t know the legislative outcome of his advocacy for several months—Congress plans to consider these issues again in December—he’s proud of the work he’s done. “It was an honor to advocate on behalf of pulmonary transplant patients, and for Temple Health as a leader in pulmonary transplant medicine,” he says.
His commitment has earned him a leadership award from the Pennsylvania Society of Respiratory Care, and a reputation as a nationally sought-out expert. It’s also what makes him right at home at the Temple Lung Center—and the center of excellence that is Temple Health.