New England Asthma Innovations Collaborative: Year One

an initiative of Health Resources in Action’s Asthma Regional Council of New England

The project described is supported by Funding Opportunity Number CMS-1C1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation

(Healthcare Innovation Award #1C1CMS331039). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

Presented at NEAIC Annual Meeting  

June 13, 2013

TRIPLE AIM

Health Care Innovation Challenge: $1 billion to

implement the most compelling

new ideas for delivering the three-part aim

Home Visiting Program• 1,400 + children• Diagnosis of asthma from authorized clinician• Aged 2 – 17 years old – • Medicaid or CHIP beneficiary (primarily)• Poorly controlled asthma - evidenced by at least one of

the following in the 12 month period prior to enrollment:– Asthma-related ER visit, – Observation stay,– Hospitalization,– Prescription for oral corticosteroids

NEAIC Intervention

New England Asthma Innovations Collaborative

I. Builds on ARC best practices

II. Three years; $4.2 million

III. Reduce disparities in asthma thru home visiting program

IV. 1,400 + children with severe asthma across NE

V. 8 Providers; 7 Medicaid Payers

VI. Train asthma workforce: CHWs and AE-Cs

OVERVIEWGoal: Create New England Asthma Marketplace

Projected Outcomes:• Enhanced quality of life and success of children with

asthma

• Reduced disparities

• Demonstrated healthcare cost savings

• New workforce (particularly CHWs and AE-Cs)

• Policy change, long-terms sustainability: insurance payment for asthma home visiting services.

NEAIC Team at HRiA

• Laurie Stillman, Principal Investigator

• Stacey Chacker, ARC Director

• Christine Gordon, ARC Project Coordinator

• Heather Nelson, Senior Research Scientist

NEAIC Partners: Health Care Providers

MA: • Children’s Hospital Boston• Boston Medical Center• Baystate Children’s Hospital

RI:• RI/Hasbro Hospital• St. Joseph’s Health Services CT: • Middlesex Hospital• Children’s Medical Group VT: • Rutland Regional Medical Center

NEAIC Partners: Health Care Payers

MA: • Neighborhood Health Plan• BMC HealthNet • Health New England

RI: Neighborhood Health Plan, RI

CT: CT Department of Social Services \Children’s Health Network (ASO) (Medicaid)

VT: Department of Vermont Health Access (VT Medicaid)

Others pending: MassHealth (Medicaid)

• American Lung Association, New England

• Boston Public Health Commission’s Community Health Education Center

• Central MA – Area Health Education Center’s Outreach Worker Training Institute

• MA Association of Community Health Workers

• CDC funded - New England State Asthma Programs

NEAIC Policy and Training Partners

NEAIC: The Project in Action

Primary intervention: Asthma Home Visits

• Assess patients’ needs and home environment• Provide asthma self-management education• Deliver cost-effective environmental supplies

• Improve quality and experience of care:oPromote asthma action plansoPromote connections to primary care & preventionoReferrals for urgently needed social serviceso Review of needs and progress o Client-centered, use of motivational interviewing

Services Recommended in:

Two Home Visiting Service models

• MA: Duplication and Modification of Krieger model: – 3-4 home visits by a CHW, overseen by an asthma nurse

trained in CHW supervision.

• RI, CT and VT: Modification of Krieger: three visits: – 1st home visit conducted by CHW and an AE-C. – 2nd & 3rd – only CHW.

Intensive Planning Time Required:• Team Building and Consensus• IRBs

• Data Security, Collection and Transfer

• IT infrastructure

• Workforce Training

NEAIC Year One Learning

Data Flow Map – An example

• Successfully managed complex federal grant• Fostered excellent relationships with regional

partners and CMS• Promoted consensus amongst providers• Sustained payer dedication• Created Robust Learning Community• Launched Intervention

NEAIC Year One AccomplishmentsRegional Capacity Building

• Workforce Development for CHWs and AE-C’s

• Strong regional and national interest

• Opportunity to impact CMS national policies

NEAIC Year One Other Accomplishments

Questions?

Contact: • Laurie Stillman, Principal Investigator at lstillman@hria.org • Stacey Chacker, ARC Director at schacker@hria.org

Acknowledgements

NEAIC is organized by the Asthma Regional Council, a program of Health Resources in Action.

The project described was supported by Funding Opportunity Number CMS-1C1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation (Healthcare Innovation Award #1C1CMS331039).

Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.