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Unlocking the Power of Home-Based Asthma Services: Model Health Benefit Packages

Developed by PHI’s RAMP and the National Center for Healthy Housing (NCHH), this report equips managed care organizations and other healthcare payers with the information they need to improve asthma management among their enrollees by ensuring the provision of asthma home visiting services. It also addresses the key roles that other community, state, and federal stakeholders play in motivating and supporting healthcare payers in this effort.

Asthma home visit

Asthma home visiting services are a proven method for improving health outcomes, lowering healthcare utilization costs, improving patient care, and reducing healthcare disparities; yet far too many people with poorly controlled asthma don’t have access to these key interventions.

Developed by PHI’s Regional Asthma Management and Prevention (RAMP) and the National Center for Healthy Housing (NCHH), Unlocking the Power of Home-Based Asthma Services: Model Health Benefit Packages equips managed care organizations (MCOs) or other healthcare payers with the information they need to improve asthma management among their enrollees by ensuring the provision of asthma home visiting services. It also addresses the key roles that other community, state, and federal stakeholders play in motivating and supporting healthcare payers in this effort.

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This report describes the scope, staffing, and services associated with home-based asthma services that identify and address environmental asthma triggers in the home environment. It also includes tiers of services (e.g., from a very basic set of services to more premium sets of services) to provide a range of options for payers at different levels of readiness to provide home-based asthma services and includes recommendations to support action from a range of critical stakeholders.

Veona Rogers client of Esperanza Community Housing Corporation’s asthma home visiting program
I can actually say that my children are living a better life because of [the home visitor]. A resource like this can change your entire life. I can honestly say it really works. It really works. Veona Rogers

Client of Esperanza Community Housing Corporation’s asthma home visiting program

Housing & Asthma: Understanding the Role of Social Determinants of Health

Social determinants of health are increasingly implicated as root causes of health disparities, and housing quality is perhaps the most critical social determinant in asthma disparities. Due to the historical legacy and ongoing impacts of redlining, structural racism and displacement, there are limited, substandard housing options in many low-income communities and communities of color.

In homes that have been poorly designed or not well maintained, common structural issues can lead to and worsen environmental asthma triggers including but not limited to mold and pests. In addition to exacerbating asthma, exposure to these triggers may also lead to the onset of asthma in otherwise healthy people, contributing to disparities in both asthma outcomes and asthma prevalence.

The good news: Asthma home visiting services are a tried-and-true method for alleviating this disparate burden. Why? One reason is that evidence shows greatest improvements in health outcomes and cost savings when targeting people with poorly controlled asthma. Another reason is that these services are often provided by professionals especially qualified to support the people most in need of help. Depending on needs and capacities, MCOs can employ a range of qualified professionals, both licensed and non-licensed, including community health workers, promotoras de salud, certified asthma educators, lay asthma educators, social workers, respiratory therapists, healthy homes specialists, nurses and others.

How to Design Home-Based Asthma Services Programs

There is no “one size fits all” approach to structuring and implementing home-based asthma services. Rather, there are many different program models, giving MCOs a great deal of flexibility for determining how best to accommodate needs of enrollees, quality assurance, staffing capabilities, community partnerships, and cost considerations.

Some MCOs may prefer to build a new asthma-specific program in-house. Others may opt to add asthma to an existing home visiting program focused on other topics and build on its established infrastructure. Still other MCOs may decide to connect with external partners such as clinics, community-based organizations, public health departments, or other third-party vendors to provide the services. Regardless of the approach your MCO takes, you’ll expand the number of valuable resources available to your members.

“The direction from policy makers at all levels to invest in community-based solutions in healthcare continues to grow and there has never been a better time for states and managed care plans to adapt evidence-based in-home asthma care programs into their community-based service packages for social determinants of health and population health investments.” – Unlocking the Power of Home-Based Asthma Services: Model Health Benefit Packages

Learn More: Technical Assistance

RAMP and NCHH offer customized technical assistance and support that can help you translate the information in this tool into concrete actions that achieve cross-sector partnerships and put sustainable, systems-level policies and programs in place. Email askanexpert@nchh.org to learn more today.

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