Medicaid Managed Care

Innovation in Action: The Improving Asthma Care for Children Program

Because children in low-income communities and minority families often face a higher incidence of asthma, Medicaid managed care organizations (MMCOs) are frequently on the front lines of managing this condition.

Imagine the impact that a few innovations could have on serving these Medicaid managed care recipients: optimizing care delivery and training for providers; improving self-management skills among patients and caregivers; reducing unnecessary hospital visits and overall costs.

The Improving Asthma Care for Children (IACC) projects supported by the Robert Wood Johnson Foundation (RWJF) not only reached for these goals—they delivered results.

Program Highlights and Outcomes

Some of the most effective asthma management practices implemented by these MMCOs included:

  • Focusing on early detection and intervention;
  • Setting up asthma registries and stratifying enrolled patients;
  • Using a variety of outreach methods to stay in touch with high-risk members;
  • Educating providers on member self-management and appropriate prescribing; and
  • Offering incentives to providers to reward high-quality asthma care.

The results these projects achieved are even more compelling. All of the projects reported significant improvements in at least one area of childhood asthma management. And many of the most effective improvements to clinical care delivery, policy and administrative operations have been adopted as standard procedures. Project-specific results include:

  • The KC CAMP Family Health Partners project in Kansas City, MO, saw significant reductions in asthma-related ER visits (45%), asthma-related hospitalizations (50%) and asthma-related treatment costs (35%) and greatly increased the number of patients with asthma action plans.
  • At Affinity Health Plan in Bronx, NY, in-patient utilization of services declined threefold, while pediatric asthma-related emergency room visits dropped by more than 400 percent. Every $1 invested in the project generated $10 in cost savings in childhood asthma care, and $3 in cost savings across the entire health plan.
  • At the Monroe Plan & ViaHealth Partnership in Rochester, NY , the percentage of participants categorized as moderate-to-severe asthmatics declined from 51 percent to 26 percent, while a series of quality-of-life surveys showed improvements in patients’ symptoms and functional limitations.

IACC Program Sites

For a profile of the program, including research strategies, tactics and results, click any of the IACC program titles below:

boy on bikeKansas City Children’s Asthma Management Program (KC CAMP)

Kansas City, Missouri

“Measuring outcomes is extremely important—it’s the key to our expansion,” says Jay Portnoy, M.D., Chief of Allergy, Asthma & Immunology at Children's Mercy Hospital. “While return on investment can be difficult to measure, we focus on things we can directly affect, such as education for patients and providers, prescription usage and emergency department visits.”


nurse and girlAffinity Health Plan

Bronx, New York

“The program really showed us the value of tracking multiple outcome metrics,” says Susan Beane, M.D., Senior Vice President and Chief Medical Officer of Affinity Health Plan. “It became the model for how we reach and intervene with patients systemwide.”

 

group

Monroe Plan & ViaHealth Partnership

Rochester, New York

“Once you have a sizable chunk of the population with asthma that understands how to better manage it, fewer resources are required to maintain good results,” says Joseph Stankaitis, M.D., Chief Medical Officer of Monroe Plan for Medical Care. “As asthma patients get engaged and educated, and the providers get onboard, it leads to long-term success.”