HEALTH RESOURCES IN ACTION
Project Title: “New England asthma innovations collaborative”
Geographic Reach: Connecticut, Massachusetts, Rhode Island, Vermont
Funding Amount: $4,040,657
Estimated 3-Year Savings: $4.1 million
The "New England Asthma Innovation Collaborative” (NEAIC) is a multi-state, multi-sector partnership convened by the Asthma Regional Council of New England (ARC), a program of Health Resources in Action (HRiA), that includes health care providers, payers, and policy makers aimed at creating an innovative Asthma Marketplace in New England that will increase the supply and demand for high-quality, cost-effective health care services delivered to Medicaid children with severe asthma. Our goal is to create a sustainable infrastructure that robustly delivers evidence-based cost-effective asthma care to New England children with severe disease, and creates viable Medicaid reimbursement mechanisms to support these programs over the long-term. The targeted population is high-cost Medicaid and CHIP pediatric patients (2 – 17 years), with a focus on those with uncontrolled symptoms that have a history of using expensive urgent care. NEAIC includes following components:
1. Workforce development: NEAIC will: a) sponsor Asthma Training to increase the number of well qualified cost-effective providers, including certified asthma educators (AE-Cs) and community health works (CHWs) with a specialty in asthma; and b) explore CHW asthma credentialing program that payers and provider practices across NE have requested and can benefit from. All of this will contribute to higher quality and culturally competent care, and we believe will help to support innovative Medicaid reimbursement as a result of demonstrated cost-effective outcomes.
2. Rapid service delivery expansion for over 1300 high-risk children with asthma in Connecticut, Rhode Island, Massachusetts, and Vermont. NEAIC employs the following components of care: 1) Asthma self-management education 2) Home environmental assessment with the provision of minor-to-moderate environmental intervention supplies to reduce asthma triggers; and 3) Use of non-physician providers shown to be cost-effective deliverers of this level of care, particularly community health workers (CHWs) and certified asthma educators (AE-Cs).
3. Committed Medicaid payers in several New England states will work to sustain these programs by piloting reimbursement methodologies with the service providers, should the service model results demonstrate the goals of delivering better health, improving care and lowering costs..
4. A Payer and Provider Learning Community across all six New England states to rapidly disseminate demonstrated improvements to the quality and cost of asthma care, share viable reimbursement systems developed, successfully incorporate CHWs into the asthma care team, and disseminate best practices. The Learning Community builds on ARC’s existing networks and partnerships across the region, and is meant to increase awareness about these successful models with the goal of broader adoption across New England.
NEAIC’s components build in continuous quality improvement measures through rigorous data collection/analysis, strong partnerships, and commitments from interested payers and policy makers. The establishment and promotion of CHWs as strong health care delivery partners addressing environmental conditions as part and parcel of the disease management program, with reimbursement by payers, make this an innovative model for broad dissemination and potential for replication across the nation.