Presentation on the New England Asthma Innovations Collaborative by Laurie Stillman and Stacey Chacker at the annual meeting of the Asthma Regional Council of New England, June 13, 2013, Shrewsbury, MA. ARC is a program of Health Resources in Action.

1. New England Asthma Innovations Collaborative:
Year One
an initiative of Health Resources in Action’s
Asthma Regional Council of New England
Presented at NEAIC Annual Meeting
June 13, 2013
The project described is supported by Funding Opportunity Number CMS-1C1-12-0001 from
Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation
(Healthcare Innovation Award #1C1CMS331039). Its contents are solely the responsibility of the authors
and do not necessarily represent the official views of HHS or any of its agencies.

2. TRIPLE AIM
Health Care Innovation
Challenge: $1 billion to
implement the
most compelling
new ideas for delivering
the three-part aim

3. NEAIC Intervention
Home Visiting Program
• 1,400 + children
•
•
•
•
Diagnosis of asthma from authorized clinician
Aged 2 – 17 years old –
Medicaid or CHIP beneficiary (primarily)
Poorly controlled asthma - evidenced by at least one of
the following in the 12 month period prior to enrollment:
–
–
–
–
Asthma-related ER visit,
Observation stay,
Hospitalization,
Prescription for oral corticosteroids

4. New England Asthma Innovations Collaborative
OVERVIEW
Goal: Create New England Asthma Marketplace
I. Builds on ARC best practices
Projected Outcomes:
II. Three years; $4.2 million and success of children with
• Enhanced quality of life
asthma
III. Reduce disparities in asthma thru home visiting program
• Reduced disparities
IV. 1,400 + childrenhealthcare cost savings NE
• Demonstrated with severe asthma across
• New workforce (particularly
V. 8 Providers; 7 Medicaid Payers CHWs and AE-Cs)
• Policy change, long-terms sustainability: insurance
payment for asthma home visiting services.
VI. Train asthma workforce: CHWs and AE-Cs

5. NEAIC Team at HRiA
• Laurie Stillman, Principal Investigator
• Stacey Chacker, ARC Director
• Christine Gordon, ARC Project Coordinator
• Heather Nelson, Senior Research Scientist

6. NEAIC Partners: Health Care Providers
MA:
• Children’s Hospital Boston
• Boston Medical Center
• Baystate Children’s Hospital
RI:
• RI/Hasbro Hospital
• St. Joseph’s Health Services
CT:
• Middlesex Hospital
• Children’s Medical Group
VT:
• Rutland Regional Medical Center

7. NEAIC Partners: Health Care Payers
MA:
• Neighborhood Health Plan
• BMC HealthNet
• Health New England
RI: Neighborhood Health Plan, RI
CT: CT Department of Social Services
Children’s Health Network (ASO) (Medicaid)
VT: Department of Vermont Health Access (VT Medicaid)
Others pending: MassHealth (Medicaid)

8. NEAIC Policy and Training Partners
• American Lung Association, New England
• Boston Public Health Commission’s Community
Health Education Center
• Central MA – Area Health Education Center’s
Outreach Worker Training Institute
• MA Association of Community Health Workers
• CDC funded - New England State Asthma Programs

9. NEAIC:
The Project in Action

10. Primary intervention: Asthma Home Visits
• Assess patients’ needs and home environment
• Provide asthma self-management education
• Deliver cost-effective environmental supplies
• Improve quality and experience of care:
oPromote asthma action plans
oPromote connections to primary care & prevention
oReferrals for urgently needed social services
o Review of needs and progress
o Client-centered, use of motivational interviewing

11. Services Recommended in:

12. Two Home Visiting Service models
• MA: Duplication and Modification of Krieger model:
– 3-4 home visits by a CHW, overseen by an asthma nurse
trained in CHW supervision.
• RI, CT and VT: Modification of Krieger: three visits:
– 1st home visit conducted by CHW and an AE-C.
– 2nd & 3rd – only CHW.

13. NEAIC Year One Learning
Intensive Planning Time Required:
• Team Building and Consensus
• IRBs
• Data Security, Collection and Transfer
• IT infrastructure
• Workforce Training

14. Data Flow Map – An example

15. NEAIC Year One Accomplishments
Regional Capacity Building
• Successfully managed complex federal grant
• Fostered excellent relationships with regional
partners and CMS
• Promoted consensus amongst providers
• Sustained payer dedication
• Created Robust Learning Community
• Launched Intervention

16. NEAIC Year One
Other Accomplishments
• Workforce Development for CHWs and AE-C’s
• Strong regional and national interest
• Opportunity to impact CMS
national policies

17. Questions?
Contact:
• Laurie Stillman, Principal Investigator at lstillman@hria.org
• Stacey Chacker, ARC Director at schacker@hria.org
Acknowledgements
NEAIC is organized by the Asthma Regional Council, a program of Health Resources in
Action.
The project described was supported by Funding Opportunity Number CMS-1C1-120001 from Centers for Medicare and Medicaid Services, Center for Medicare and
Medicaid Innovation (Healthcare Innovation Award #1C1CMS331039).
Its contents are solely the responsibility of the authors and do not necessarily
represent the official views of HHS or any of its agencies.