The objective of this analysis was to evaluate and report on the economic impact of implementing an integrated, quality, and operational improvement program on
chronic obstructive pulmonary disease (
COPD) care from acute through
post-acute care settings. This initiative was established in a cohort of 12 hospitals in Alabama and sought to address
COPD readmission through improved workflows pertaining to early diagnosis, efficient
care transitions, and patient visibility across the entire
care episode. Implementation of the initiative was influenced by lean principles, particularly cross-functional agreement of workflows to improve
COPD care delivery and outcomes. A budget impact model was developed to calculate cost savings directly from objective data collected during this initiative. The model estimated payer annual savings over 5 years. Patients were classified for analysis based on whether or not they received
noninvasive ventilation. Scenario analyses calculated savings for payers covering different
COPD cohort sizes. The base case revealed annual per patient savings of $11,263 for patients treated through the quality improvement program versus traditional care. The model projected cumulative savings of $52 million over a 5-year period. Clinical incorporation of
non-invasive ventilation (NIV) resulted in $20,535 annual savings per patient and projected $91 million over 5 years. We conclude that an integrated management program for
COPD patients across the
care continuum is associated with substantial cost savings and significantly reduced
hospital readmissions.