COPD is a Top 3 Health Benefit Claims Cost

COPD is a significant cost, but it has often been overlooked

The amount that employers spend on the treatment of Chronic Obstructive Pulmonary Disease (COPD) can vary greatly depending on several factors, including the size of the employer, the number of employees with COPD, and the cost of treatment in the specific geographic region.

According to a study by the National Institute for Health Care Management, the average cost of treating COPD in the United States was estimated to be $2,967 per patient per year in 2009. This figure includes the cost of medications, hospitalizations, emergency room visits, and other medical treatments.

It’s important to note that this is just an estimate, and the actual cost of COPD treatment can vary greatly depending on the severity of the condition, the cost of treatment in a specific geographic region, and the availability of cost-effective treatment options.

Employers can work with their health insurance providers to better understand the cost of COPD treatment and to develop strategies to manage those costs. By taking a proactive approach to managing the cost of COPD treatment, employers can reduce the impact on their benefits costs and improve the overall health and well-being of their employees.

How can we get to the bottom of the real cost?

Health plans & employers can identify the cost of Chronic Obstructive Pulmonary Disease (COPD) in claims by using several methods, including:

1. Claims data analysis: This involves analyzing claims data to determine the number of COPD-related claims, the cost of those claims, and the utilization of services. This information can be used to estimate the total cost of COPD to the health insurance plan.
2. Diagnosis codes: Health insurance plans use diagnosis codes to identify when a patient has been diagnosed with COPD. This information can be used to track the number of COPD patients, the utilization of services, and the cost of those services.
3. Cost of care analysis: This involves analyzing the cost of care for COPD patients compared to other patient populations. This information can be used to estimate the impact of COPD on the overall cost of care for the health insurance plan.
4. Predictive modeling: Health insurance plans can use predictive modeling to forecast the future cost of COPD based on current trends and utilization patterns.

Avoidable Hospitalizations & ER Visits

Hospitalizations and emergency room (ER) visits can also contribute significantly to the cost of Chronic Obstructive Pulmonary Disease (COPD) treatment. COPD patients are at increased risk of exacerbations, which can result in hospitalizations or ER visits. These events can be costly, both in terms of the cost of the hospitalization or ER visit and the subsequent care that may be required.

Hospitalizations and ER visits can also result in lost productivity and wages, which can add to the overall cost of COPD. Additionally, hospitalizations and ER visits can be traumatic for patients and can disrupt their daily lives, which can impact their quality of life.

Health insurance plans can take several steps to manage the cost of hospitalizations and ER visits for COPD patients, including:

1. Promoting early intervention: By encouraging patients to seek treatment early, before an exacerbation becomes severe, health insurance plans can reduce the risk of hospitalizations and ER visits.
2. Encouraging self-management & respiratory therapy/remote monitoring: By providing patients with the tools and resources they need to manage their COPD, health insurance plans can reduce the risk of exacerbations and hospitalizations.
3. Improving care coordination: By improving care coordination between providers, health insurance plans can ensure that patients receive timely and appropriate care, which can reduce the risk of hospitalizations and ER visits.

Potential Over-Use of Expensive Drugs

Chronic Obstructive Pulmonary Disease (COPD) can have specific drug-related costs. COPD is a chronic condition that requires long-term treatment, and patients with COPD often need to take multiple medications to manage their symptoms and prevent exacerbations.

Some of the medications used to treat COPD include bronchodilators, corticosteroids, antibiotics, and oxygen therapy. These medications can be expensive and can add significantly to the overall cost of COPD treatment.

In addition to the cost of the medications themselves, there may also be costs associated with administering the medications, such as inhalers, nebulizers, or oxygen equipment.

It’s important for health insurance plans to understand the drug-related costs associated with COPD and to develop strategies to manage those costs.

Respiratory Therapy & Remote Monitoring: A Long-Term Solution

Respiratory Therapy combined with remote monitoring is a proven method for managing and reducing the symptoms of Asthma and COPD. Studies show that Respiratory Therapy works as well as or better than other approaches and has effects that last even after the therapy is done, reducing the long tail of costs while developing a healthier and happier workforce.