For health plans: HCO Respiratory
Setup costs only. No PMPM. No PEMPM. Just a piece of the savings we generate.
We know our program works. So we put it on the line. You set the baseline. We share in the savings. If we do not deliver, we do not get paid.
Every asthma or COPD flare starts a clock on the measures you report. Follow-up within 30 days. Readmission within 30 days. Our care team works inside that window.
1 in 3
Commercial ED visits involves asthma or COPD. At $1,150 per visit.
2 in 5
Medicare ED visits involves asthma or COPD. At $2,600 per visit.
Up to $40K
Additional annual cost for a COPD member with common comorbidities.
The spend your actuaries already know about
Stop paying for sick care. Start paying for health.
Same program. A different scorecard in each line of business.
Commercial
Public ratings, accreditation, cost
Stronger NCQA Health Plan Rating and, for Marketplace plans, your HealthCare.gov stars
New for 2026: asthma follow-up (AAF-E), plus COPD follow-through (PCE)
High-cost and rising-risk cohort identification
Comorbidity cost reduction: diabetes, obesity, hypertension, anxiety
Typical: 193% Year 1 ROI, 234% Year 2. 2x ATS efficacy threshold.
Medicare Advantage
Reach or protect 4 stars
Plan All-Cause Readmissions (PCR): triple-weighted, and respiratory flares are among its most preventable drivers
Follow-up after ED visits (FMC) and transitions of care (TRC): COPD and asthma both count
ED utilization reduction: 2 in 5 Medicare members visit the ED annually
Medicaid
Withholds, growth, pediatric asthma
Pediatric asthma: follow-up after acute asthma visits (AAF-E), ages 7 and up
Protect quality withholds, earn performance bonuses, and gain auto-assignment share where your state uses ratings
Proven reach into hard-to-engage populations
Multi-channel engagement: phone, text, app, video and in-person
HRSN design: HEPA filtration, Wi-Fi, pest control support
Built for the moments your quality team is measured on.
A flare triggers a short window. What happens next shows up in your scores. We work inside that window.
| Measure | What it tracks | What we do |
|---|---|---|
| AAF-E | Follow-up after an acute asthma visit | We catch the event and help the member get a follow-up visit booked within 30 days. |
| PCE | Medicine after a COPD flare | Outreach and education after the flare, so members fill and use what was prescribed. |
| EDU | ED visits | Regular data review flags a flare early, before it becomes an ED visit. |
| PCR, TRC, FMC | Readmissions and follow-up (Medicare Advantage) | Escalation protocols catch decline early and support a safer handoff home. |
Telehealth follow-up visits count toward AAF-E. That makes the gap easier to close.
Questions health plans ask us
Before you commit.
What is HCO's payment model for health plans?
No PMPM. No PEMPM. Health plans pay setup costs only, then share in the savings generated as the population improves. Members who achieve self-management graduate, permanently reducing plan cost. Year 2 ROI is higher than Year 1 because the model is designed to accrete value, not perpetuate costs.
How much of this do we actually have to manage?
Very little. We handle everything: actuarial savings analysis, member recruitment, care navigation, and comorbidity action plans. You get clear reporting, in the measure language your quality team already uses. We do the work.
What do poorly controlled asthma and COPD actually cost our plan?
For commercial plans, an asthma member with common comorbidities costs $10,000 to $15,000 more per year than baseline. A COPD member costs $30,000 to $40,000 more. For Medicare Advantage, asthma members with comorbidities add $8,000 to $10,000; COPD members add up to $18,000 above baseline. Your actuarial team already knows these numbers.
What is the evidence base for this approach?
The CDC identified intensive self-management education as one of only four evidence-based interventions for asthma, reducing ED visits by 45% and hospitalizations by 56%. HCO delivers 2x the American Thoracic Society clinical efficacy threshold and has been independently validated by the Validation Institute, the first wearable and only respiratory program they have ever validated.
Will this help our Star Ratings?
If you run Medicare Advantage, it is built to. The measures closest to our work are readmissions (PCR, triple-weighted), transitions of care (TRC), and follow-up after ED visits (FMC). For commercial and Medicaid plans, the same work supports your NCQA Health Plan Rating. For Marketplace plans, it also supports your QRS rating on HealthCare.gov. We will always be clear about which rating we mean.
Which Medicaid measures do you support?
It depends on your state contract, so we start there. AAF-E and PCE apply in most states. Pediatric asthma is usually the best place to begin.
Does HCO work with Value-Based Orgs?
Yes. HCO works with Value-Based Orgs across both respiratory and neurological care: two programs, one partner, with incentives aligned from day one.
Track record
Validated outcomes. Across populations. Independently verified.
Exclusive partnership
Lehigh Valley Business Coalition on Health
The exclusive virtual respiratory care provider for LVBCH. 400,000+ covered lives. A referenceable contract with measurable outcomes.
In-network partners
Evry Health and Sounder Benefits
Contracted and in-network across multiple plan and benefit platforms, with more in active development.
AAFA HEAL program
Chosen by the Asthma and Allergy Foundation of America
The only virtual respiratory care program selected by the leading respiratory patient advocacy organization in the country.
Let's talk.
Bring your actuaries. Bring your CMO. Bring your quality team.