We created a series of gamified acute-care COPD case simulations with real-time feedback over 16 weeks then performed a year-over-year analytic comparison of the cost, length of stay (LOS), and revisits over the six months prior to the introduction of the simulated patients, the four months while caring for the simulated patients, and the six months after. In total, 245 hospitalists from 15 facilities at Novant Health participated. Over the 16 weeks that the providers were actively engaged in the short cases, evidence-based quality scores in the cases increased by 12%. Importantly, these improvements translated in real-world data with a 19% reduction in COPD-related pharmacy costs, and an annualized impact of 233 fewer inpatient days for COPD patients and 371 fewer revisits, leading to inpatient savings of $1M. Healthcare, 2021