Effective In-home Asthma Education Model for Adults: Impacts, outcomes and lessons learned

Asthma is a serious chronic lung disease estimated to affect 25.9 million Americans.  Of these, 13.2 million Americans had an asthma attack. Asthma affects people from all segments of society, but the burden is not equally shared across racial and ethnic groups. Children and people living below the poverty level are among the groups most likely to suffer from severe asthma attacks, hospitalizations and death. Asthma costs our nation $56 billion dollars annually. 

To reduce the burden of asthma in Long Beach, CA, the health department partnered with the ALA to bring an evidenced-based adult asthma education program, Breathe Well, Live Well (BWLW), to their case management program. The program was adapted as one-on-one education taught by Community Health Workers (CHWs). Data was collected and analyzed from 2012-2014. 

Participants in the case management program showed improvement in symptom control and asthma self-management skills, resulting in a conservative estimate of $5.7 million (61%) decrease in asthma care costs.

The in-home asthma education presented by CHWs using the BWLW program is a model of an effective intervention that shows results of reducing medical costs. According to new Medicaid regulations under 42 C.F.R. 440.130, effective January 1, 2014, CMS allows state Medicaid to reimburse for preventative services provided by professionals that may fall outside of the state’s clinical licensure system (e.g., asthma educators, healthy home specialists or CHWs), as long as services were initially recommended by a physician.  If states choose to opt-in to the rule, CHWs would have an opportunity to get reimbursement for programs like this.