Asthma Management

To 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:

Insurance Coverage for Asthma: A New England Gap Analysis – December 2010 In order to better understand the extent to which insurance policies in New England reflect and support national guidelines and published research, ARC, in partnership with the CDC-funded asthma programs in the region’s health departments, designed and conducted an insurance coverage survey in the summer of 2010. The survey responses were collected from 25 public (Medicaid) and private (commercial) payers across the six New England states. This report provides a general analysis of the responses and identifies where there are gaps in coverage. With this understanding, ARC and its partners can knowledgably collaborate with public and private health payers to work towards reimbursement policies that will serve to improve health outcomes and simultaneously reduce expensive, preventable, urgent care visits.
Investing in Best Practices for Asthma: A Business Case – August 2010 Update This report updates our first Business Case published in 2007. Two primary developments motivated the update. First, the National Asthma Education Prevention Program (NAEPP) Expert Panel, which is responsible for regularly updating the national best practice guidelines for asthma management, and the Centers for Disease Control and Prevention’s Task Force on Community Preventive Services (CDC Task Force), each published major reviews—including economic evaluations—of the research on asthma education and environmental interventions. Second, programs translating research on comprehensive asthma management into practice have proliferated. Therefore, in addition to summarizing the NAEPP and the CDC Task Force reviews, this update describes six evidence-based programs which are achieving their goals of bringing asthma under control cost-effectively.

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.