UMass Medical School asthma bundled payment pilot featured in Center for Health Care Strategies brief

March 10, 2016

The Children’s High-Risk Asthma Bundled Payment demonstration, a partnership between UMass Medical School and MassHealth, the state Medicaid program, is featured in a Center for Health Care Strategies brief about innovative models that include support services.

The brief, “Using Medicaid Resources to Pay for Health-Related Supportive Services: Early Lessons,” examines strategies in Massachusetts, Oregon, Vermont, New York and Utah for using Medicaid funds to cover the costs of non-clinical interventions such as housing and training.  Those services may be provided through accountable care organizations (ACOs), health homes, community care teams, accountable communities for health and other delivery system reforms.

The Center for Health Care Strategies interviewed Katharine London, MS, the UMass Medical School program lead, for the brief. London is a principal at the Center for Health Law and Economics, a unit within UMass Medical School’s Commonwealth Medicine division.

Massachusetts’ payment initiative was geared toward children ages 2 to 18 with high-risk asthma, including patients whose disease is poorly controlled and those who have been treated at a hospital for asthma or had a corticosteroid prescription for asthma during the past 12 months.

The bundled payment would give participating providers a monthly fee for asthma-related goods and services that are not traditionally covered by insurance, including home visits from community health workers and supplies such as vacuum filters and mattress covers to reduce triggers. The funding environment changed before the initiative was implemented.

The brief details hurdles faced in establishing the asthma demonstration: obtaining federal approval for the payment model; obtaining stakeholder consensus for key program elements; calculating the return on investment; reaching consensus on the method for identifying eligible patients; and making sure services are delivered.

UMass Medical School’s Commonwealth Medicine division began collaborating with MassHealth on the asthma initiative in 2011, soon after legislation required the state to develop a bundled payment pilot for pediatric asthma. 
 

Related Links