Abstract Introduction Patients with chronic obstructive pulmonary disease (COPD) and severe emphysema can significantly benefit from bronchoscopic lung volume reduction (BLVR). A dedicated BLVR program at an academic medical center has been shown to be economically valuable, sustainable, and effective in attracting referrals from other institutions. However, its value in a community hospital setting remains largely unstudied. Therefore, we conducted a study to evaluate the financial impact of a BLVR program implemented in a community hospital. Methods We retrospectively reviewed patients referred to the Interventional Pulmonology (IP) clinic at Saint Francis Hospital (Hartford, CT) for BLVR evaluation between January 2022 and December 2024. Data were collected on all outpatient diagnostic tests, procedures, and follow-up visits related to valve candidacy and care up to one year after endobronchial valve (EBV) placement. Revenue was estimated using hospital payer-negotiated charges standardized to Medicare reimbursement rates for outpatient services and actual reimbursement data for EBV procedures and associated hospitalizations. Costs were estimated using the cost-to-charge ratio (CCR). The contribution margin ratio was calculated to assess profitability. Statistical analyses were performed using R Studio, with t-tests and chi-square tests applied where appropriate. Methods were modeled after a previously published study from Beth Israel Deaconess Medical Center (BIDMC), allowing comparison between a tertiary community and an academic center. Results Among 48 referred patients, 36 completed BLVR evaluation, of whom 14 (39%) underwent EBV placement and 22 (61%) were deemed ineligible. All valve recipients were treated with Zephyr valves and had an average hospital stay around 4 days. Estimated total revenue generated from the 14 EBV cases was estimated to be in the range 420, 000-560, 000, corresponding to 30, 000-40, 000 per patient. For non-valve candidates, total revenue was estimated to be in the range 28, 000-115, 000, corresponding to 1, 200 to 5, 200 per patient. The combined inpatient and procedural revenue for EBV placement totaled approximately 335, 000 with an estimated cost of 200, 000, yielding a contribution margin of 40% (9, 600 per patient). Conclusion BLVR programs can be successfully implemented in tertiary community hospitals with favorable financial performance and sustainability. Revenue was generated not only from the procedure itself but also from the comprehensive pre-evaluation process, including workups for patients who did not undergo EBV placement. The observed 40% contribution margin highlights the program’s sustainability, underscoring the broader feasibility of expanding interventional pulmonology services beyond academic centers to community hospital settings. This abstract is funded by: None
Dagher et al. (Fri,) studied this question.