Chronic Obstructive Pulmonary Disease (COPD) afflicts 24 million adult Americans and represents the 3rd leading cause of death. COPD is also the 5th most costly chronic disease in the US with attributable direct healthcare costs estimated at $49 billion! Given the edifice of fee-for-service payment in US healthcare, we have allowed the care of COPD patients to become fragmented and inconsistent.  We continue to see care of this chronically ill population wrought with poor clinical outcomes and a high economic burden. However, we are now seeing that value-based care is beginning to catalyze COPD care delivery innovation for a more promising future!

Our guests this week are Geoff Matous and Dr. Abi Sundaramoorthy of Wellinks – a digital health company offering the first-ever integrated, virtual chronic obstructive pulmonary disease management solution.  These two leaders are connecting the dots on COPD to create a constellation of care that includes pulmonary rehabilitation, personalized coaching and monitoring, and connected devices. Disruption in payment incentives have spawned care delivery innovation at Wellinks, and they are poised for further success of their platform with the promise of global capitation in ACO REACH and MA plans. Don’t miss out on the important conversation to learn how partnership and innovation can transform your healthcare organization’s COPD population health playbook strategy!
Episode Bookmarks:
01:30 Register today for the “Population Health Equity: The North Star for Value”(December 1, 2022)
03:00 COPD affects 24 million adults and represents the 3rd leading cause of death and the 5th most costly chronic disease in the US.
03:30 The direct healthcare costs of COPD is $49 billion (and growing!) with COPD-related hospital admissions costing upwards of $40k
04:00 Introduction to Geoff Matous and Dr. Abi Sundaramoorthy
05:00 November is National COPD Awareness Month
06:00 COPD is an Ambulatory Care Sensitive Condition (i.e. a chronic disease for which good outpatient care potentially prevent the need for hospitalization)
07:30 Balancing the population health management requirements for COPD (Coding and Documentation, Quality measures, and Cost Reduction)
08:30 Impacting patient behavioral change to impact COPD-related healthcare utilization
09:30 “COPD Total Cost of Care reduction is a significant opportunity in value-based care that has been left untouched for far too long.”
10:00 Why are we still in the early stages of COPD Care Delivery Innovation?
11:00 Employer-sponsored plans will not drive digital health innovation for improved COPD management – it must be driven by ACOs and MA plans.
12:00 Geoff speaks to the advantages of virtual-first COPD care in a risk-based payment model.
12:30 75% of the total direct COPD cost is tied to exacerbations -- how can chronic care management programs work to more effectively manage COPD patients?  
14:00 Dr. Abi speaks about the challenges of health systems and ACOs developing a robust infrastructure for COPD virtual care.
15:30 43% of patients with COPD exacerbation will die within one-year of being discharged from hospital!
16:00 How the Wellinks Virtual COPD Management Solution approaches patient behavioral change.
17:30 The difference in approaches between “Pulmonary Health” and “Pulmonary Rehab” and how SDOH-based interventions can improve COPD management.
19:00 Health system attempts to help COPD patients self-manage their disease will fail if it is a “hero project” tied to temporary grant funding.
20:00 “Our call to action is to explore what can be done beyond the standard COPD care management playbook to improve patient outcomes and experience.”
21:00 99% of COPD patients have 1 comorbid condition, 87% have 3+ comorbidities!
22:00 Dr. Abi explains why COPD is a complex disease to manage and why addressing comorbidities alone will not be enough to reduce COPD exacerbations.
23:00 Behavioral health challenges associated with ...

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