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Community Asthma Initiative: Cost Analyses using Claims Data from a Medicaid Managed Care Organization.

Authors
  • Bhaumik, Urmi1, 2
  • Sommer, Susan J2
  • Lockridge, Ryan3
  • Penzias, Rebecca2
  • Nethersole, Shari1, 4
  • Woods, Elizabeth R2
  • 1 Office of Community Health, Boston Children's Hospital, Boston, MA, USA.
  • 2 Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA.
  • 3 Neighborhood Health Plan, Boston Children's Hospital, Boston, MA, USA.
  • 4 Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA.
Type
Published Article
Journal
Journal of Asthma
Publisher
Informa UK (Taylor & Francis)
Publication Date
Mar 01, 2020
Volume
57
Issue
3
Pages
286–294
Identifiers
DOI: 10.1080/02770903.2019.1565825
PMID: 30663906
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Objective: Use claims data to examine the cost benefit of the Community Asthma Initiative (CAI), a Boston area nurse-supervised community health worker (CHW) asthma home-visiting program. Methods: The reduction in asthma treatment costs was assessed using Massachusetts claims data from one Medicaid Managed Care Organization (MCO) in the north east that included all costs between January 1, 2011 and December 31, 2016. The data was used to determine asthma-related utilization cost reductions between 1 year pre- and 1, 2 and 3 years post-intervention. The cost reductions for 45 CAI patients and 45 cost-matched comparison patients were measured. Return on investment (ROI) was computed as the difference in cost reduction for CAI patients and a cost-matched comparison population divided by CAI program cost. Results: The excess reduction in per patient asthma-related utilization costs among CAI patients compared to the comparison population was $806 (p = 0.047), $1,253 (p = 0.01) and $1,549 (p = 0.005) between 1 year pre- and 1, 2 and 3 years post-intervention. These yielded adjusted ROI's of 0.31, 0.78 and 1.37 after 1, 2 and 3 years post-CAI intervention. Conclusions: The reduction in asthma utilization costs of a home visit program by nurse-supervised CHWs exceeds program costs. The findings support the business case for the provision of secondary prevention of home-based asthma services through reimbursement from payers or integration into Accountable Care Organizations (ACOs).

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