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The Community Asthma Initiative (CAI) has had remarkable results improving asthma care for children in Boston. These successes led CAI to submit a proposal to Medicaid with the help of Children's Office of Government Relations. The paper suggested that it was cost effective for Medicaid to use the CAI model to deliver asthma treatment and care to patients throughout the state. At the same time, the CAI and Government Relations teams pursued a parallel strategy working with asthma champions in the State Legislature to develop a payment mechanism that would support improvements in asthma care. The proposal directed the Executive Office of Health and Human Services (EOHHS) to develop a bundled payment plan for high-risk pediatric asthma patients in the Medicaid program. This would fund some or most of the comprehensive and coordinated care provided by CAI and similar intervention programs.
The Legislature added this bundled payment language to the 2011 state budget and now CAI and Government Relations are working with EOHHS and Medicaid to develop an implementation plan. This pilot program would provide comprehensive and tailored care, asthma education and home-based environmental interventions to high-risk pediatric asthma patients and families across Massachusetts.
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