COPD Management in a Value-Based Care Clinic Compared to Fee-for-Service Clinics

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-8-2026

Abstract

Fee-for-service (FFS) healthcare models financially incentivize higher volumes of services regardless of their impact on patient outcomes, whereas value-based care (VBC) models aim to improve health outcomes while reducing unnecessary costs. Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide, yet it remains under-diagnosed and often inadequately managed. Preventive tools such as the COPD Assessment Test (CAT), a validated eight-item questionnaire, and pulmonary function tests (PFTs) play key roles in early detection and disease management. However, limited data exist comparing the utilization of these assessments between VBC and FFS care models. This study aims to compare CAT and PFT completion rates among patients with identified COPD risk receiving care in a VBC clinic versus FFS clinics over a six-month period.

A retrospective analysis was conducted using SlicerDicer to evaluate patients with identified COPD risk. The treatment group consisted of a value-based care clinic within Corewell Health Family, Internal, and Pediatric Medicine, including data from seven providers. The comparison group included 42 fee-for-service clinics within the same health system. Monthly completion percentages for the COPD Assessment Test (CAT) and pulmonary function tests (PFTs) were calculated for each clinic type and compared across a six-month period in 2024.

Across all six months studied, CAT and PFT completion rates were consistently higher in the value-based care clinic compared to fee-for-service clinics. The value-based care clinic demonstrated sustained, higher monthly completion percentages for both assessments. Fee-for-service clinics showed lower and relatively stable completion trends over time. These findings suggest greater adherence to recommended COPD assessment practices within the value-based care model during the study period.

CAT and PFT completion rates were higher in the value-based care clinic compared to fee-for-service clinics, suggesting that value-based models may support more consistent COPD monitoring. Although patient populations could not be fully controlled and COPD risk was the primary sampling factor, these findings highlight the potential role of value-based care in improving adherence to recommended COPD assessments. Future studies should adjust for additional variables and evaluate other preventive services and cost outcomes.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 1979

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