Patients with chronic obstructive pulmonary disease, or COPD, represent a huge chunk of the nation’s health care costs.
In 2010, COPD-related costs totaled $49.9 billion, including $29.5 billion in direct health care expenditures, $8 billion in indirect morbidity costs and $12.4 billion in indirect mortality costs. It is a major cause of hospitalizations in the United States.
Much of the cost and harm to quality of life caused by COPD can be mitigated. In a value-based care environment, health care providers are turning to population health management as a way to improve the quality and delivery of care and control costs.
Segmenting a patient population lays the groundwork for devising effective care management and patient engagement programs. For many organizations, this has included retooling their approach from a reactive model to one that is driven by predictive, proactive intervention and care.
Using advanced analytics, organizations are gaining valuable insight into critical diagnostic factors. Such factors include pulmonary function tests, Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, existence of comorbidities or complications such as asthma, and adherence to recommended vaccination guidelines. With this information, they are stratifying patients by risk and planning their outreach efforts.
Sentara Medical Group, for example, used risk scores to identify patients with COPD and other chronic conditions who were at highest risk for an impending hospitalization. Sentara, which has 380 primary care and specialty care physicians in Virginia and North Carolina, chose to first focus on patients who fell in the 90th percentile risk category for chronic conditions. By leveraging the information in their patients’ profiles, physicians were able to identify patients for outreach, as well as recognize and act on critical changes in patient care or outcomes.
Providers can also use analytics to track clinical, operational and financial performance. Dashboard reports, for instance, allow organizations to take a deeper look at their clinical performance, laying the groundwork for initiatives designed to promote physician adoption of evidence-based medicine and drive improvements in quality, safety and efficiency.
For more on using analytics to improve quality, download our playbook “Maximize the value of your COPD population health programs with advanced analytics”
–Jeremy Orr, MD, MPH, Chief Medical Officer, Optum Analytics