Value-Based Healthcare — A Catalyst for Change

Many people would agree that healthcare systems in the United States are in need of reform. The call for change is easily demonstrated in the record $4 trillion spent on healthcare in 2021. Despite outpacing all other countries when it comes to healthcare expenditures, the U.S. regularly falls short in comparison to others when it comes to positive health outcomes.

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In an effort to cut costs, drive patient satisfaction, and deliver effective care, the attention of those in the healthcare industry has shifted to the Value-Based Healthcare delivery model. In this article, we will explore the benefits of Value-Based Care, how it can positively impact patients, payers, and providers, and why Wellinks embraces this model as a catalyst for change for those managing and living with COPD.

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Value-Based Care is a Powerful Tool in Chronic Disease Management

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The traditional Fee for Service (FFS) healthcare model and the incentives it creates have contributed to inflating the cost of care and creating a gap between prescribed treatments and intended results. With the Value-Based Care (VBC) model, incentive structures are realigned to the effectiveness and quality of services rendered rather than the volume of services delivered. VBC opens the door for the types of care that can reduce the chronic disease burden while helping patients live healthier lives. This includes an emphasis on preventative treatment rather than episodic care, which is critical in chronic disease management to prevent further progression.

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The VBC model can significantly impact a disease like COPD as it is a progressive, non-curable disease with a history that demonstrates exacerbations cause long-term deficits to the patient's health. Preventative care and avoiding exacerbations is managing this condition. Beyond payment model innovation allowing for innovative approaches to disease management, our research shows people living with COPD want access to this type of care.

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In a patient survey conducted by the COPD Foundation, 32% of respondents were admitted to the hospital at least once, and 41% visited the ER at least once. Applying the preventative care focus of VBC can lower the number of ER visits, hospitalizations, and related treatment expenses of COPD patients. Not only does VBC shift the way providers are paid but it also changes how patient care is managed, resulting in healthier communities and more significant savings for the healthcare industry.

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The Traditional FFS Environment hinders COPD Disease Management

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COPD is responsible for nearly $49B in healthcare costs and is anticipated to cost the system close to $800 B in the next 20 years. 65% of these costs are attributed to inpatient management of exacerbations, including preventable ED visits and hospitalizations. Additionally, it is common for COPD to have follow-on impacts on other diseases such as diabetes, hypertension, and heart disease. Educating patients on how to properly manage their COPD, increasing physical activity without exacerbation, and giving them access to self-management support through health coaching are critical. These strategies, representative of the VBC approach, all positively impact other diseases, thus lowering costs overall. In fact, patients who receive self-managed care have reduced hospitalizations by 39.8% and ER visits by 41%.

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Our current FFS environment puts undue restrictions on high-quality, cost-effective care. Pulmonary rehabilitation access and availability is a prime example of where this model falls short. Not only are there not enough facilities in the U.S.,  but patients are also only allotted so many visits to limit the cost of this service, as providers get reimbursed per session. The current incentive structure of FFS is not feasible for pulmonary rehabilitation clinics as they are reimbursed less than half in comparison to cardiac rehab clinics, and significantly less than physical therapy clinics

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Alternatively, the VBC model motivates payers and providers to give longitudinal, preventative care that improves clinical outcomes and reduces high-cost events like exacerbations. By financially supporting these goals, a VBC environment incentivizes pulmonary rehab and self-management support that have been proven to reduce these acute events.

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Virtual Care, Self-Management, and Preventative Care - the Future of Chronic Disease Treatment

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The VBC model encourages a team-based approach with providers and other clinical staff to empower patients to take better care of themselves in between visits by utilizing prevention strategies and care management programs. It has been demonstrated that patients with care teams employing VBC are more likely to receive SDoH support, engage in conversations about treatment options, coordinate with outside resources, and maintain their prescribed care.

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But how exactly are patients able to access these resources consistently and effectively? Through human connection and embracing technology.

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Online engagement tools, apps, wearable technology, and telemedicine are valuable self-management tools that increase access to health coaches, improving health outcomes and lowering overall costs. These tools are customized to fit patients' needs, enabling the users to understand their conditions and treatment plans and allowing providers to collect essential health data that can be used to track performance.

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Virtual care is critical as it increases access to disease management by meeting patients where they are. Many COPD patients are older and live in rural areas, often struggling with transportation to care. According to the COPD Foundation's survey, 35% of respondents claim that pulmonary rehab is not convenient for them to access. In comparison, 29% of respondents say they haven't had as much access to care since the onset of the COVID-19 pandemic. By integrating virtual solutions that can be accessed from the home, providers and health plans have the opportunity to bridge these gaps.

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Furthermore, people living with COPD want these options to control their health. 72% of those surveyed are interested in doing more to improve how their COPD is managed, and 59% either use or are very willing to use an app to manage their COPD.

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This is where Wellinks comes in with personalized, virtual-first COPD management. Wellinks breaks down barriers for patients, providing the evidence-based care they need and deserve outside the four walls of a clinic. Patients are supported through virtual pulmonary rehabilitation, health coaching, and monitoring through connected devices and an easy-to-use smartphone app. Wellinks devices are simple for daily use and advanced enough for care teams to monitor their progress remotely and intervene, be it activating a self-management strategy or escalating to an appropriate site of care.

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Wellinks Embraces Value-Based Care for a Healthier Future

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While nearly all illnesses, diseases, and chronic health issues would experience a positive lift from the VBC model, COPD is among the many where treatment options and quality of life largely depend on patient motivation and access to care.

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Wellinks is leading the revolution of COPD care by focusing on supporting patients' needs outside of the hospital. For patients, this model and Wellinks' programs are improving their health. For providers and payers, programs are being implemented to deliver excellent care with lower associated costs.

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With value-based healthcare as a catalyst for change, Wellinks is at the forefront of reimagining COPD care. Learn more today.