Asthma Management

The Insurance Check Sheet for EmployersTo improve health outcomes for asthma patients, the health care sector must more widely adopt and reimburse for best practices in effectively managing asthma. Research has shown that asthma programs must address both the clinical and environmental aspects of the disease in a complementary manner. ARC is committed to improving the quality of asthma care by promoting best practices and policies which foster excellence in environmental and clinical asthma management.

Rationale: First, the vast majority of funds spent on asthma currently support medical management, but education and environmental interventions that could prevent asthma exacerbations and reduce severity are rarely given the same level of attention by clinicians. Second, reimbursement policies for asthma do not necessarily reflect the current state of understanding of best practices.

ARC's work

In 2003, ARC launched the Environmental Investments Initiative to align asthma services and reimbursement policies with best practices in asthma management.  ARC's work in this area has included:

• Conducting structured interviews of providers and payers on their receptivity to and knowledge of environmental interventions that can control costs and improve health outcomes. Results are available for download here.
• Interviewing environmental researchers to determine how they view the state of the science and to what extent they develop research with policy and practice objectives in mind. Results available here.
• Developing white papers that summarize emerging research on the benefits of specific environmental approaches, highlight model programs, and discuss financing options which New England health payers may want to pursue.
• Holding symposia for health departments, health payers, and providers. Details from symposia available here.
• Successfully working with a number of managed care organizations to implement expanded services for their asthma patients.

Highlighted ARC Publications:

Asthma: A Business Case for Employers and Health Care Purchasers
The report details three strategies employers can pursue to cost-effectively bring asthma under control: 1) Aligning employee health benefits with recommended best practices for asthma; 2) Supporting employees in overcoming barriers to self-management of asthma; and 3)  Ensuring healthy work environments.  Published by ARC and Lowell Center for Sustainable Production.

The Insurance Check Sheet for Employers

Investing in Best Practices for Asthma:
A Business Case for Education and Environmental Interventions (2007)
This highly-acclaimed publication documents the cost benefits of payers investing in best practices, including environmental strategies. All of the research was conducted by ARC, in collaboration with the University of Massachusetts Lowell's Environmental Health Initiative.

What the Health Sector needs to Implement Best Practices for Asthma:
A Perspective from Providers (2008)
In 2008, ARC and the University of Massachusetts Lowell convened health care leaders across Massachusetts to identify policy changes needed to improve asthma care and outcomes for their most vulnerable populations, resulting in a provider consensus statement containing recommendations for health payers, government officials, and the health care system itself.

Enhancing Asthma Management Using In-Home Environmental Interventions (2006)
A Review of Public Health Department Programs

Improving Asthma Management by Addressing Environmental Triggers: Challenges and Opportunities for Delivery and Financing (2004)
This white paper provides an update about emerging research on effectiveness of specific indoor environmental interventions for asthma and suggests steps that the health sector could take to ensure access to these interventions.

Additional Information:

For Health Plans, Purchasers, and Policy Specialists
For Providers
For Patients