Ep 109 – Effective COPD Management to Achieve Value-Based Care Goals, with Dr. MeiLan Han

What this episode covers

Healthcare costs due to Chronic Obstructive Pulmonary Disease (COPD) is in excess of $32 billion due to high rates of re-hospitalizations and ED visits, complex and inefficient clinical pathways during transitions of care, and intensive resource burden on clinical and administrative staff. The average cost per COPD patient readmission in the U.S. typically falls between $9,000 and $12,000. Unlike other high cost chronic conditions like CHF and diabetes, it seems that many ACOs are not as purposeful in their targeting of COPD as part of their population health playbook. This is a massive unmet need with many COPD patients experiencing fragmented and inconsistent care that drives poor clinical outcomes and high economic burden. Consequently, COPD now represents the 3rd leading cause of death and the 5th most costly chronic disease in the US. What is it about this particular chronic condition that makes it so less prone for population health management with ACOs and other risk-bearing entities?  Why is this chronic disease so universally undiagnosed? How can we implement chronic care management programs that actually make an impact on patient lung health and clinical outcomes? For anyone that wants to know more about “Effective COPD Management to Achieve Value-Based Care Goals”, look no further than this week’s episode with Dr. MeiLan Han. She is Professor and Chief of Pulmonary and Critical Care Medicine at the University of Michigan who is widely known for her expertise on Chronic Obstructive Pulmonary Disease. Dr. Han is a leading pulmonologist, researcher, lung health advocate, consultant, and national volunteer spokesperson for the American Lung Association. She is also the author of the new book, “Breathing Lessons: A Doctor's Guide to Lung Health.”   Episode Bookmarks: 01:30 Introduction to Dr. MeiLan Han (pulmonologist, COPD researcher, lung health advocate, author, and speaker) 05:30 Origins in rural, small town America that led to a career in pulmonary medicine and research 07:00 “Many people that have lung damage and don’t know it. We don’t do a good job of diagnosing lung disease in this country.” 07:30 Only half of the 25-30M Americans with COPD even have a diagnosis! 08:00 Undiagnosed lung disease led to server morbidity and increased mortality during COVID-19 pandemic 08:30 Research continues to be under-funded due to lack of awareness of lung health importance 09:20 11M Americans suffering from long-haul COVID 09:40 Societal threats to lung health (ex: air pollution, hazardous chemicals, plastic microparticles in lungs) 10:00 “The pandemic was a golden opportunity to raise awareness for lung health, but now people are starting not to listen.” 12:00 The impact of race and socioeconomic status on COVID death rates, and overall poor lung health in marginalized communities 13:30 COPD is more common in rural communities where there is less access to care 14:20 Virtual care is not a perfect solution in areas where there is a “digital divide” 16:00 Half of adult Americans have at least one chronic condition and more than two thirds of Medicare patients have two or more. 17:00 Ambulatory Care Sensitive Conditions as an opportunity for ACOs to achieve cost savings 18:30 The challenges of developing and implementing COPD Quality Improvement Measures 19:00 Difficulties in collecting data from spirometry and PFTs in the Electronic Medical Record 20:00 Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations and the difficulties of tracking symptoms and exacerbations 22:00 The lack of reporting requirements on COPD has limited progress of health systems and EHR companies