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.
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.
| ASPECT | TRADITIONAL COPD CARE | VALUE-BASED COPD CARE |
| Care Model | Fragmented care with multiple, non-coordinated providers |
Integrated, coordinated care across providers |
| Patient Education | Often inadequate, leading to poor self-management |
Comprehensive education to empower patients in managing their condition |
| Provider Incentives | Fee-for-service, incentivizing volume of services | Incentives based on patient outcomes and quality of care |
| Care Approach | Reactive, treating symptoms as they arise |
Proactive, focusing on prevention and management of chronic conditions |
| Health Outcomes | Generally poorer, with higher rates of complications and hospital readmissions | Improved outcomes with reduced hospital readmissions and complications |
| Healthcare Costs | Higher due to frequent hospitalizations & emergency care | Potential to lower overall costs through efficient, preventive care |
| Patient-Centeredness | Limited focus on individual patient needs and preferences | High focus on personalized care tailored to individual patient needs and preferences |
| Coordination Between Providers | Often lacking, leading to gaps in care and communication | Strong coordination, ensuring seamless transitions and comprehensive care |
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
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.
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.
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.
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.
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.
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 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.
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
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.
1. Ford, E. S., Mannino, D. M., Wheaton, A. G., Giles, W. H., Presley-Cantrell, L., & Croft, J. B. (2013). Trends in the Prevalence of Obstructive and Restrictive Lung Function Among Adults in the United States. Chest, 143(5), 1395–1406. https://doi.org/10.1378/chest.12-1135
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
6. Shah, T., Press, V. G., Huisingh-Scheetz, M., & White, S. R. (2016). COPD Readmissions: Addressing COPD in the Era of Value-based Health Care. Chest, 150(4), 916–926. https://doi.org/10.1016/j.chest.2016.05.002
7. Press, V. G., Myers, L. C., & Feemster, L. C. (2020). Preventing COPD readmissions under the Hospital Readmissions Reduction Program: How far have we come? Chest, 159(3). https://doi.org/10.1016/j.chest.2020.10.008
8. Struik, F. M., Lacasse, Y., Goldstein, R. S., Kerstjens, H. A. M., & Wijkstra, P. J. (2014). Nocturnal noninvasive positive pressure ventilation in stable COPD: A systematic review and individual patient data meta-analysis. Respiratory Medicine, 108(2), 329–337. https://doi.org/10.1016/j.rmed.2013.10.007
9. Murphy, P. B., Rehal, S., Arbane, G., Bourke, S., Calverley, P. M. A., Crook, A. M., Dowson, L., Duffy, N., Gibson, G. J., Hughes, P. D., Hurst, J. R., Lewis, K. E., Mukherjee, R., Nickol, A., Oscroft, N., Patout, M., Pepperell, J., Smith, I., Stradling, J. R., & Wedzicha, J. A. (2017). Effect of Home Noninvasive Ventilation With Oxygen Therapy vs Oxygen Therapy Alone on Hospital Readmission or Death After an Acute COPD Exacerbation. JAMA, 317(21), 2177. https://doi.org/10.1001/jama.2017.4451
10. Elshof, J., Vonk, J. M., van der Pouw, A., van Dijk, C., Vos, P., Kerstjens, H. A. M., Wijkstra, P. J., & Duiverman, M. L. (2023). Clinical practice of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. Respiratory Research, 24(1). https://doi.org/10.1186/s12931-023-02507-1
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
12. Lareau, S. C., & Hodder, R. (2011). Teaching inhaler use in chronic obstructive pulmonary disease patients. Journal of the American Academy of Nurse Practitioners, 24(2), 113–120. https://doi.org/10.1111/j.1745-7599.2011.00681.x
13. Polsky, M., Moraveji, N., Hendricks, A., Teresi, R. K., Murray, R., & Maselli, D. J. (2023). Use of Remote Cardiorespiratory Monitoring is Associated with a Reduction in Hospitalizations for Subjects with COPD. International Journal of Chronic Obstructive Pulmonary Disease, Volume 18, 219–229. https://doi.org/10.2147/copd.s388049
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
15. Ezeamii, V. C., Okobi, O. E., Wambai-Sani, H., Perera, G. S., Zaynieva, S., Okonkwo, C. C., Ohaiba, M. M., William-Enemali, P. C., Obodo, O. R., Obiefuna, N. G., Ezeamii, V. C., Okobi, O. E., Wambai-Sani, H., Perera, G. S., Zaynieva, S., Okonkwo, C. C., Ohaiba, M. M., William-Enemali, P. C., Obodo, O. R., & Obiefuna, N. G. (2024). Revolutionizing Healthcare: How Telemedicine Is Improving Patient Outcomes and Expanding Access to Care. Cureus, 16(7). https://doi.org/10.7759/cureus.63881
16. Al-Anazi, S., Al-Omari, A., Alanazi, S., Marar, A., Asad, M., Alawaji, F., & Alwateid, S. (2023). Artificial intelligence in respiratory care: Current scenario and future perspective. Annals of Thoracic Medicine, 19(2). https://doi.org/10.4103/atm.atm_192_23