Pulmonary rehabilitation (PR) is an evidence-based therapeutic option for patients with chronic respiratory diseases, particularly COPD. PR has been shown to reduce the number of hospital days for patients with COPD, acute COPD exacerbations, and hospital readmissions, which are clinical endpoints with a high impact on quality of life and health care costs. 1 Additionally, multiple studies have demonstrated that PR is equally or more cost-effective than tiotropium or long-acting bronchodilators, which are mainstays of current COPD treatment. 2 Access to PR and Implications on Justice Despite its many benefits, PR is severely underutilized, with only approximately 3% of Medicare beneficiaries with COPD receiving PR. 3 This is particularly true among vulnerable populations; white race, higher socioeconomic status, insurance plans with higher reimbursements rates, and proximity to urban areas are associated with increased PR use. 4 During the periexacerbation period of COPD in particular, the efficacy of PR on recovery, survival, and readmission is more dramatic, yet its inaccessibility is even more pronounced. 5

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