There is a well-established relationship between home-care visits for patients who have uncontrolled asthma and lowering emergency care requirements. However, the type of home-care visits that have been shown to be effective are not often implemented due to financial limitations on patients and insurance companies. The rate of return on investment that such a program could result in has not been studied thus far. A study funded by a grant from the National Institute of Environmental Health Sciences and the Department of Housing and Urban Development attempted to conduct a long-term analysis of the financial and health benefits of home-care visits for young patients with uncontrolled asthma.
The study enrolled 289 children aged 2 to 13 years old between 2009 through 2014. All patients had uncontrolled asthma. In-home asthma management care was conducted by community health workers in five visits over the course of five months. These visits consisted of direct asthma management as well as environmental remediation. Indoor environment and survey data was also collected. All health costs were accessed through Massachusetts Medicaid.
The community health worker asthma home visits improved trigger management, clinical results, and lowered Medicaid costs. Although the first two results listed have already been established, it is the Medicaid cost saving that this study uniquely focused on, since this result is not particularly well established in past research.
The study concluded that community health worker visits significantly improved clinical outcomes for participants, but that they also lowered the Medicaid costs for pediatric patients. This means that these visits are advisable both as a way to improve public health, and as a way to help reduce costs for this more vulnerable population. A major part of this lowered cost comes from the lower frequency of costly emergency department visits.
Marshall ET, Guo J, Flood E, Sandel MT, Sadof MD, Zotter JM. Home Visits for Children With Asthma Reduce Medicaid Costs. Prev Chronic Dis 2020;17:190288. DOI: http://dx.doi.org/10.5888/pcd17.190288