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Variation in pediatric asthma quality improvement programs by managed care plans.
Michael D Cabana1, Kevin J Dombkowski, Esther Y Yoon
1Child Health Evaluation and Research Unit, Department of Pediatrics, University of Michigan Health Care System, Ann Arbo, MI 48109-0456, USA. mcabana@med.umich.edu
Summary
Pediatric asthma quality improvement (QI) programs in managed care show wide variation. Many programs lack allied health professional and pharmacy involvement, indicating a need for standardized, cost-effective QI strategies.
Area of Science:
- Health Services Research
- Pediatric Pulmonology
- Quality Improvement Science
Background:
- Asthma quality improvement (QI) programs are prevalent in managed care.
- Limited understanding exists regarding the scope and content of these QI initiatives.
Purpose of the Study:
- To assess the comprehensiveness of asthma QI programs within Michigan managed care plans serving pediatric Medicaid populations.
- To identify variations in program components, including provider, allied health, pharmacy, and member services.
Main Methods:
- Cross-sectional survey of all Michigan managed care plans serving the pediatric Medicaid population.
- Semi-structured interviews to evaluate QI program content and scope.
Main Results:
- All QI initiatives included physician- and patient-directed components.
- Only 50% included allied health professionals, and 25% included pharmacy-directed components.
- Wide variation observed in content, format, incentives, professional inclusion, and outcome goals.
Conclusions:
- Significant variation exists in pediatric asthma QI approaches across managed care organizations.
- There is a lack of information on effective and cost-efficient methods for improving pediatric asthma quality at the plan level.