The Value of a High-Volume Bronchoscopic Lung Volume Reduction Program for Patients With Severe Emphysema

BACKGROUND: Bronchoscopic lung volume reduction (BLVR) has emerged as a promising therapeutic option for patients with COPD.The development of a dedicated BLVR program requires significant resources, both from an interventional pulmonology (IP) team and from the medical center.The financial value of this program is important to assess to develop a feasible and sustainable plan for providing this service in the future.RESEARCH QUESTION: Can a BLVR program bring value to a medical center in terms of patient referrals, revenue, and contribution margin?STUDY DESIGN AND METHODS: We retrospectively reviewed the charts of patients who were referred for BLVR to the interventional pulmonology clinic at Beth Israel Deaconess Medical Center (BIDMC).Patient demographics were obtained.Outpatient services used to determine candidacy for endobronchial valve placement were analyzed and revenue was estimated.For patients who had valve placement, revenue from the bronchoscopic procedure and subsequent inpatient hospitalization was calculated and the contribution margin of the procedure was estimated.RESULTS: An estimated total of $1 to 1.4 million in revenue was generated in the workup and placement of endobronchial valves for 37 patients.The total revenue for the care of 52 patients deemed not to be candidates for the valve procedure was $144,000 to $170,000.The contribution margin for the procedure was estimated to be 25%.The median length of stay was 3 days.Among all 89 patients referred for BLVR, 26 referrals were made to other specialties at BIDMC during workup.Of these patients, 69.6% were new patients referred to BIDMC for BLVR.INTERPRETATION: In addition to the established therapeutic benefit of BLVR for patients with COPD, a BLVR program in a dedicated, specialized center is economically valuable and sustainable, attracts referrals from other medical centers and health care systems, and generates internal referrals within the medical center.