Using Social Impact Financing to Improve Asthma Outcomes

The Childhood Asthma Leadership Coalition hosted a webinar on September 29, 2014 to discuss efforts underway to use a social impact bond (SIB) financing model to address the range of complex issues that children with asthma face to get their chronic condition under control. SIBs are a potentially powerful tool for improving services for medically underserved children with asthma.

This webinar explored three emerging social financing models that tackle chronic asthma, working to demonstrate the dual social and financial benefits of up-front investment in asthma management and prevention. The following presenters discussed SIB models underway in Fresno, CA, Alameda County, CA and Baltimore, MD:

  • Tony Iton, MD, JD, MPH: Senior Vice President, Healthy Communities, The California Endowment
  • Anne Kelsey Lamb, MPH: Director, Regional Asthma Management & Prevention (RAMP)
  • Ruth Ann Norton: President & CEO, Green & Healthy Homes Initiative
  • Alice Yu: Associate, Third Sector Capital Partners
  • Maria Hernandez, PhD: President, Impact4Health; Special Advisor on Social Impact Investing, Health Research for Action, UC Berkeley School of Public Health

In its most basic form, private investors participating in a SIB model pay the upfront costs for providing social services - from services related to criminal justice, to education, to health - and government agencies repay investors with a return on their investment if the program achieves agreed-upon outcomes (such as decreased healthcare expenditures).  

SIB models focused on asthma are designed to demonstrate that by educating patients and taking action against asthma triggers at home, insurers can achieve significant savings on emergency room visits, hospitalizations and other healthcare costs.

Download the webinar slides. 

Play the webinar recording. 

Paying for Asthma Management at School

Asthma is the most common chronic condition among school-aged children in the United States, and the school setting is an important place for asthma management. The availability of effective school-based asthma services depends greatly on a school system’s ability to obtain Medicaid reimbursement or other funding. Current federal Medicaid policy limits reimbursement for some of the services that students with asthma require at school.

The Childhood Asthma Leadership Coalition, National Association of School Nurses and the National Alliance for Medicaid in Education, Inc., sponsored this Thursday, January 30, 2014 webinar to explore reimbursement hurdles and new opportunities for delivering effective health services in schools for students with asthma. Presenters described public and private funding sources used by school districts to cover nursing services; examined recent legal challenges to the “free care rule,” which is an obstacle to Medicaid reimbursement in schools; and discussed new ways to increase access to health services in schools. The webinar also examined opportunities under health reform law and recent changes to federal Medicaid policy that could allow community health workers to help deliver preventive services to children in schools.

Webinar presenters:

  • Greg Morris, JD, Executive Director, LEAnet: A National Coalition of Local Education Agencies
  • Mary Kusler, Director, Government Relations, National Education Association
  • Janet Lowe, MA, RN, LSN, CPNP, Coordinator, Saint Paul Public Schools Third-Party Reimbursement Program; Member, National Association of School Nurses
  • Katie Horton, RN, MPH, JD, Research Professor at the George Washington University Department of Health Policy, moderator.

The Influence of Setting on Care Coordination for Childhood Asthma

Effective care coordination can improve quality of life for children with asthma and their families. Using a treatment approach that marries health care and social support services can help manage symptoms, create asthma care plans and better monitor progress.

But does the care setting have an impact on the design of the care coordination program? And can childhood asthma be managed the same way at school as it is in a community health center or hospital system?

The Merck Childhood Asthma Network (MCAN) sponsored this September 24, 2013, webinar on “The Influence of Setting on Care Coordination for Childhood Asthma.” Presenters explored how diverse settings influence childhood asthma care coordination program design, focusing on care implementation through school district nursing services, urban pediatric health systems, federally qualified health centers, and in partnership with multiple providers and organizations.

Webinar presenters included:

  • Dr. Floyd J. Malveaux, Executive Director, Merck Childhood Asthma Network
  • Noreen M. Clark, PhD, Director, Center for Managing Chronic Disease, University of Michigan School of Public Health
  • Dr. Victoria Persky, Principal Investigator, Addressing Asthma in Englewood Project, Professor of Epidemiology, University of Illinois at Chicago School of Public Health
  • Dr. Marielena Lara-Greenberg, Co-Principal Investigator, La Red Project, RAND Corporation
  • Dr. Gilberto Ramos, Co-Principal Investigator, La Red Project, University of Puerto Rico
  • Dr. Kimberly Uyeda, Principal Investigator, LAUSD Asthma Program, Director, Student Medical Services, Community Partnerships and Medi-Cal Programs, Los Angeles Unified School District
  • Dr. Tyra Bryant-Stephens, Principal Investigator, CHOP Asthma Care Navigator Program, Director and Founder, Community Asthma Prevention Program, Children’s Hospital of Philadelphia (CHOP)

Access a PDF version of the slideshow here.

CMS Announces Webinar Series

The Center for Medicaid and CHIP Services is hosting a new technical assistance series, Promoting Prevention in Medicaid and CHIP. This series is part of a new and expanding effort to support state efforts to improve beneficiary access to high-quality preventive health services that would great benefit children with asthma.

Working with Managed Care Organizations to promote prevention
May 21, 3:00-4:00 p.m. EDT
877-267-1577; Meeting ID: 8494

Using health IT to improve access to preventive services
May 30, 2:00-3:00 p.m. EDT
877-267-1577; Meeting ID: 0374

Building partnerships and financing prevention in Medicaid and CHIP (In partnership with ASTHO)
June 13, 2:00-3:00 p.m. (Eastern)
877-267-1577; Meeting ID: 2168

Developing Mechanisms for Sustainable Funding of Community Asthma Management

On February 6, 2013, the Childhood Asthma Leadership Coalition hosted a webinar entitled: Developing Mechanisms for Sustainable Funding of Community Asthma Management. The webinar examined new and ongoing efforts underway in Massachusetts to address the burden of childhood asthma through delivery system innovations and new reimbursement models that promote community-based interventions to reduce asthma triggers in homes and community settings.

The following presenters participated in this webinar:

  • Dr. Monica Le, MD, MPH, Associate Medical Director, Office of Clinical Affairs, Commonwealth Medicine, Center for Health Policy and Research
  • Jean Zotter, JD, Director, Massachusetts Asthma Prevention and Control Program, Massachusetts Department of Public Health
  • Stacey Chacker, Director of the Asthma Regional Council of New England, a program of Health Resources in Action

Presenters discussed how stakeholders in Massachusetts have worked to build partnerships, engage payers, and develop the business case necessary to move innovative payment and delivery models forward to give children better access to asthma services in their community.

Slides from the webinar can be found in the attached document; a recording of the webinar is also available. When the recording page opens, click the “Playback” button () and follow the instructions to begin watching the webinar. During the webinar, we experienced technical difficulties at 32:24. Please advance to the next section at the 45:30 timestamp to continue following the session.

To continue the dialogue started during the webinar, the Coalition has also released a white paper entitled “Using Medicaid to Advance Community-Based Childhood Asthma Interventions: A Review of Innovative Medicaid Programs in Massachusetts and Opportunities for Expansion under Medicaid Nationwide.”

The Affordable Care Act and Childhood Asthma

On September 13, 2012, the Childhood Asthma Leadership Coalition hosted a webinar examining the Affordable Care Act and opportunities for childhood asthma. The following presenters participated in this webinar:

  • Sara Rosenbaum, JD, Harold and Jane Hirsch Professor of Health Law and Policy, The George Washington University School of Public Health and Health Services
  • Katherine Horton, JD, MPH, RN, Research Professor, The George Washington University School of Public Health and Health Services
  • Mary-Beth Harty, JD, MPH, Assistant Research Professor, The George Washington University School of Public Health and Health Services

Presenters took a close look the opportunities that exist within the Affordable Care Act for advancing the field of childhood asthma, and what advocates can do now to take advantage of new opportunities under health reform. Slides from the webinar can be found in the attached documenta recording of the webinar is also available.

The Affordable Care Act: Potential Implications for Individuals with Asthma

In October 2012, Professors Katie Horton and Mary-Beth Harty, both of George Washington University, presented at a meeting hosted by the American Lung Association on the Affordable Care Act and asthma. Professors Horton and Harty discussed health reform and its intersection to the programs offered under the National Asthma Control Program. Slides from the webinar can be found in the attached document.