Chronic Obstructive Pulmonary Disease (COPD) is a major public health challenge, affecting millions of people worldwide. According to Ford et al. (2013), COPD is a leading cause of morbidity and mortality, with a significant burden on healthcare systems.1 The Global Initiative for Chronic Obstructive Lung Disease (GOLD) reports that COPD is responsible for a substantial proportion of hospital admissions and readmissions, placing a significant strain on healthcare resources.2
In response to these challenges, value-based care has gained significant attention in recent years, particularly in the management of chronic diseases like COPD. This approach involves a shift from traditional fee-for-service models to a payment system that rewards healthcare providers for delivering high-quality, patient-centered care that improves outcomes and reduces costs. Apria Healthcare is at the forefront of this shift, offering innovative solutions and personalized respiratory care plans that aim to reduce hospital admissions and enhance patient outcomes. Read along as we discuss how leveraging value-based COPD care can transform patient care and healthcare systems.
THE NEED FOR VALUE-BASED CARE IN COPD MANAGEMENT
Value-based care is built on the principles of delivering high-value healthcare, which is defined as the best possible health outcomes achieved at the lowest possible cost.3 In the context of COPD management, value-based care involves a multidisciplinary approach that focuses on preventing hospitalizations, improving patient outcomes, and reducing healthcare costs.4
Current COPD care models have several limitations, including fragmented care, inadequate patient education, and lack of coordination between healthcare providers.4 All too often, these limitations mean people experience inconsistent healthcare, are readmitted to hospitals, and end up with an increase in medical bills and overall poor outcomes. Value-based care inspires healthcare providers to prioritize patient-centered care, where the whole person—not just their COPD symptoms—gets attention and support.
TRADITIONAL VS. VALUE-BASED COPD CARE
THE BURDEN OF COPD ON HEALTHCARE SYSTEMS
COPD is a significant burden on healthcare systems, with high rates of hospitalizations and frequent readmissions. According to the GOLD reports, COPD is responsible for a substantial proportion of hospital admissions and readmissions, placing a significant strain on healthcare resources.5 The economic burden of COPD is also significant, with estimates suggesting that COPD accounts for over $32 billion in annual costs for the US healthcare system.5
REDUCING HOSPITAL READMISSIONS: THE ROLE OF VALUE-BASED CARE
Frequent hospitalizations are a major concern for COPD patients, leading to poor health outcomes, increased healthcare costs, and a decreased quality of life.6 With some of the highest hospital readmission rates globally, the US has a major issue on its hands. Enter value-based care models—powerful tools for revamping the way we approach healthcare. By paying providers based on outcomes rather than services, models like bundled payments and accountable care organizations promote collaborative, sustainable care that helps patients avoid the turmoil of hospital revisit.
Moreover, proactive care from providers like Apria Healthcare and post-discharge follow-ups can reduce hospital readmissions by identifying and addressing potential complications early, reducing the need for hospitalization.
HOW APRIA FACILITATES VALUE-BASED CARE
Apria Healthcare plays a crucial role in facilitating value-based care by providing comprehensive post-discharge support and home-based healthcare solutions. Their proactive approach includes regular follow-ups, patient education, and the use of advanced technologies to monitor patient health. This ensures that potential complications are identified and managed early, significantly reducing the likelihood of hospital readmissions. By focusing on patient outcomes and continuous care, Apria helps to lower healthcare costs and improve the quality of life for COPD patients.
THE ROLE OF NON-INVASIVE VENTILATION (NIV) AT HOME
A key component of Apria’s value-based care approach is the integration of non-invasive ventilation (NIV) for COPD patients, particularly those with severe disease. NIV has been shown to improve patient outcomes, reduce hospitalizations, and improve survival rates.8 Early adoption of home-based NIV can also decrease healthcare costs.
Clinical evidence supports the efficacy of NIV in improving lung function, reducing the work of breathing, and improving gas exchange, which is crucial for patients with acute hypercapnic respiratory failure.9, 10 Additionally, the use of NIV in acute care settings has been associated with shorter hospital stays and lower mortality rates.11 These benefits highlight the importance of integrating NIV into COPD management plans to optimize health outcomes and reduce the overall burden on healthcare systems.
IMPROVING PATIENT ADHERENCE TO COPD TREATMENTS
Medication and device adherence are critical components of COPD management, but patients often face challenges in adhering to treatment regimens. Healthcare providers play a crucial role in enhancing adherence through education, follow-up, and digital health tools.12 Personalized care plans and remote patient monitoring can also encourage adherence to therapies, improving patient outcomes and reducing healthcare costs.
THE IMPORTANCE OF PERSONALIZED CARE PLANS
Personalized care plans are critical to improving patient outcomes in COPD management. When healthcare providers customize care to meet the unique needs of each patient, they can boost patient involvement, lower the chances of hospital readmissions, and improve overall health outcomes. Creating individualized care plans also aids in spotting high-risk patients early, allowing for timely interventions and preventing potential complications.
THE ROLE OF REMOTE PATIENT MONITORING (RPM) IN COPD CARE
Remote patient monitoring (RPM) is a promising solution to improving patient outcomes in COPD care. RPM can identify potential complications early, reducing the need for hospitalization and improving patient outcomes. A study by Harris et al. (2024) concluded that RPM was associated with reductions in post-hospitalization mortality and hospital readmissions for COPD patients.14
In fact, another study found that RPM was associated with a significantly lower rate of unplanned hospitalizations per patient per year.13 This reduction in unplanned hospitalizations can, in turn, reduce the burden on healthcare facilities and staff, leading to enhanced patient satisfaction.
Source: (Polsky et al., 2023)
A study by Polsky et al. (2023) on the use of RPM for patients with COPD showed that of the patients who had at least one hospital admission pre-initiation of RPM, 79.4% experienced a reduction in hospitalizations, 10.8% had the same number, and 9.8% experienced an increase.13
APRIA’S ROLE IN THE CARE CONTINUUM
Apria Healthcare is committed to supporting patients from the first diagnosis by offering vital education and early intervention resources. Recognizing the importance of early intervention and COPD management, Apria's programs are tailored to equip patients with the knowledge they need, provide essential equipment, and emphasize the significance of treatment adherence for better outcomes.
Continuous support is fundamental to Apria’s approach. Respiratory therapists and healthcare professionals provide personalized care and collaborate with physicians to adjust treatment plans as needed. Through regular home visits, telehealth services for remote consultations, advanced remote patient monitoring devices to track utilization and other therapy triggers, and trending other diagnostic testing metrics like oxygen saturation and CO2 levels, Apria’s team ensures timely reporting to physicians and care teams. They also provide patients with the self-administered COPD Assessment Test (CAT) and track changes over time to assess signs of effective therapy or identify persistent symptoms that need early intervention strategies. By communicating symptoms timely, patients can collaborate with their physician and healthcare provider to discuss other innovative treatment options when appropriate, such as BiPAP devices, non-invasive ventilation, and HFCWO therapy.
FUTURE DIRECTIONS IN COPD VALUE-BASED CARE
Emerging trends, such as telehealth, remote patient monitoring, and artificial intelligence, offer promising solutions to improving COPD care. Telemedicine, for example, can improve patient engagement, reduce hospital readmissions, and enhance patient outcomes by allowing the patient to engage with their clinician more often without the burden of traveling to a care center.15 Artificial intelligence can also play a critical role in COPD care, enabling data-driven interventions that improve patient outcomes and potentially reduce healthcare burdens.16
CONCLUSION
Value-based care offers a promising solution to the challenges of COPD management, particularly in reducing hospital readmissions, improving patient outcomes, and reducing healthcare costs. By leveraging non-invasive ventilation, improving patient adherence, and adopting innovative models of care, healthcare providers can revolutionize COPD management and improve patient outcomes.
At Apria, we are committed to supporting these value-based strategies. Our comprehensive respiratory care services are designed to enhance patient-centered care, leveraging the latest evidence and emerging trends to improve COPD management and reduce the burden of this debilitating disease. We address gaps in care through our follow-up programs, ensuring continuous communication with providers. Additionally, our use of remote patient monitoring helps track patient progress and adherence, fitting seamlessly into system-wide value-based care models.
Sources
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2. Global Initiative for Chronic Obstructive Lung Disease (GOLD). (2020). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. In Global Initiative for Chronic Obstructive Lung Disease. https://goldcopd.org/wp-content/uploads/2019/12/GOLD-2020-FINAL-ver1.2-03Dec19_WMV.pdf
3. Porter, M. E. (2010). What Is Value in Health Care? The New England Journal of Medicine, 363(26). https://doi.org/10.1056/NEJMp1011024
4. American Journal of Managed Care. (2023). Leveraging GOLD Guidance and Value-Based Strategies in the Management of COPD. Www.ajmc.com. https://www.ajmc.com/view/leveraging-gold-guidance-and-value-based-strategies-in-the-management-of-copd
5. Løkke, A., Lange, P., Lykkegaard, J., Ibsen, R., Andersson, M., de Fine Licht, S., & Hilberg, O. (2021). Economic Burden of COPD by Disease Severity – A Nationwide Cohort Study in Denmark. International Journal of Chronic Obstructive Pulmonary Disease, 16, 603–613. https://doi.org/10.2147/copd.s295388
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11. Farmer, M. J. S., Callahan, C. D., Hughes, A. M., Riska, K. L., & Hill, N. S. (2024). Applying Noninvasive Ventilation in Treatment of Acute Exacerbation of COPD Using Evidence-Based Interprofessional Clinical Practice. Chest, 165(6), 1469–1480. https://doi.org/10.1016/j.chest.2024.02.040
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14. Harris, S., Paynter, K., Guinn, M., Fox, J., Moore, N., Maddox, T. M., & Lyons, P. G. (2024). Post-hospitalization remote monitoring for patients with heart failure or chronic obstructive pulmonary disease in an accountable care organization. BMC Health Services Research, 24(1), 1–10. https://doi.org/10.1186/s12913-023-10496-6
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