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White Paper Makes the Case for Expanding Pay-for-Performance Programs to Chronic Obstructive Pulmonary Disease

PHOENIX and WASHINGTON – November 9, 2009 – Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of death in the nation. A new white paper, released today at the National Business Coalition on Health’s annual conference will help health care purchasers implement physician measurement and reward programs to improve the quality of care for COPD patients. Prepared by Discern Consulting, the paper is also available for download, visit http://www.nbch.org/NBCH/files/ccLibraryFiles/Filename/000000000471/COPD%20White%20Paper%20Technical%20Version%20FINAL.pdf COPD%20White%20Paper%20Technical%20Version%20FINAL.pdf.

Similar to other chronic diseases, poor outcomes and costs associated with COPD could be reduced through improved health care management. COPD patients nationwide often do not receive the care they need and a recent study found thatCOPD patients receive recommended care only about half of the time.^* When COPD patients receive poor quality care there is a corollary increase in complications related to their disease. Increased complication rates have a direct relationship to increased cost of care.

"Early experiments with pay-for-performance (P4P) have shown that physicians are able to improve the quality of care they deliver, and that increased payment can be a motivation to do so," said Guy D'Andrea, president, Discern Consulting.

Analysis shows that the average annual cost of medical complications for a COPD patient is almost $3,000. Reducing the complication rate could yield significant savings and improved quality of life for COPD patients. The savings generated could be used to fund P4P payments to physicians while also creating a dividend for health care purchasers sponsoring the P4P program.

Bridges to Excellence, the nation’s most extensive effort to recognize and reward high-performing physicians, developed a program to assess physician performance in managing patients with COPD and are encouraging health plans and employers to create financial incentives tied to that assessment. Details are available at http://bridgestoexcellence.org/.

As P4P programs become more established and mainstream, it will be important for health care purchasers to expand their scope to include the wide range of clinical challenges affecting patients. Given its prevalence and impact on patient health, COPD is an appropriate candidate for pay-for-performance.

About Discern Consulting

Discern is a health care policy consulting organization focused on improving health systems by aligning incentives with high‐quality care. Discern has extensive experience developing and implementing pay‐for‐performance and other value‐based purchasing programs for leading health care organizations. Discern Consulting specializes in decision analysis and support, including ROI analysis, financial modeling and simulation. For more information, visit www.discernconsulting.com.

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^* McGlynn, et al. The Quality of Obstructive Lung Disease Care for Adults in the United States Adherence to Recommended Processes. Chest, 2006; 130(6),1844‐1850. http://www.chestjournal.org/content/130/6/1844.full. Accessed September 15, 2009.