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The economic impact of an urban asthma management program
Michelle M Cloutier1, Scott D Grosse, Dorothy B Wakefield
1Department of Pediatrics, University of Connecticut Health Center, Farmington, USA. mclouti@ccmckids.org
Insights
The Easy Breathing asthma management program significantly reduced healthcare costs for urban children. Medicaid managed care plans would have seen a positive return on investment (ROI) by funding the program
Area of Science:
- Pediatric Asthma Management
- Health Economics
- Public Health Interventions
Background:
- Asthma is a major chronic respiratory disease in children, particularly in urban settings.
- Effective asthma management programs are crucial for reducing healthcare utilization and costs.
- The Easy Breathing program aimed to improve asthma care for children in a low-income urban community.
Purpose of the Study:
- To evaluate the cost-effectiveness of the Easy Breathing asthma management program.
- To calculate the potential return on investment (ROI) for Medicaid managed care plans.
- To assess the program's impact on asthma-related health services utilization.
Main Methods:
- A cross-sectional study analyzed clinical and economic data for 3298 children with asthma.
- Costs were calculated per participating child over three years (July 1998-June 2001).
- Differences in healthcare costs between participants and non-participants were determined using Medicaid reimbursement rates.
Main Results:
- Start-up costs were $28.95 per child in year 1; operating costs averaged $10.28 in years 2-3.
- The program achieved a mean cost reduction of $36.72 per child annually in years 2-3.
- Medicaid managed care plans could have saved approximately $26.44 per child annually, with a potential ROI of $3.58 per dollar spent.
Conclusions:
- The Easy Breathing program effectively reduced overall healthcare costs for urban children with asthma.
- Reimbursing program operating costs would have yielded a positive ROI for Medicaid managed care plans.
- This study highlights the economic benefits of comprehensive asthma management interventions.
Objectives:
To examine costs associated with an asthma management program that reduces asthma-related health services utilization and to calculate potential return on investment (ROI) from the Medicaid managed care plan perspective.
Study Design:
Cross-sectional.
Methods:
Clinical and economic data were obtained for 3298 ethnically diverse children with asthma (48% with persistent asthma) who resided in a poor urban community (Hartford, Connecticut) and were enrolled in Easy Breathing, an asthma management program for pediatricians. We calculated the cost per participating child with asthma during the first 3 years (July 1998 to June 2001) relative to the difference in costs for participating and nonparticipating children calculated by applying Medicaid reimbursement rates to data on services.
Results:
Start-up costs were $28.95 per child with asthma in year 1, and operating costs averaged $10.28 in years 2 and 3. The mean reduction in costs was $36.72 per child per year in years 2 and 3. If Medicaid managed care plans had been charged an amount equal to program operating costs after year 1 ($10.28 per child with asthma per year), at-risk health plans could have incurred cost savings of approximately $26.44 per child with asthma per year. The potential ROI for years 2 and 3 was $3.58 per US dollar spent.
Conclusions:
Easy Breathing reduced overall costs of care for urban children with asthma of varying severities. If managed care plans held at risk by Medicaid had reimbursed program operating costs for participants in Easy Breathing, they would have experienced a positive ROI.
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