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We are uniquely able to identify health issues affecting large numbers of people in our communities through the claims data we have for the millions of members we serve. We can use our claims data to find patterns of unusually high spending for treatment of common diseases, and then work with organizations in the community to address the problem.
In 2012, we identified childhood asthma as one area of opportunity where we could make a big difference. Together with the American Lung Association of Texas, we launched the Enhancing Care for Children with Asthma project, an effort to help improve asthma care for high-risk children.
To get started, we used our claims data to decide which communities across the state had the greatest need. We also identified the primary care clinics and federally qualified health centers serving large groups of high-risk patients with asthma in those communities. This allowed us to focus our outreach by providing training and resources to the health care providers who need it most.
The project uses a training program based on the National Asthma Education Prevention Program created by the National Heart, Lung and Blood Institute.
Clinic staff are trained in all aspects of asthma management, from proper diagnosis to asthma management. The clinics were also armed with educational materials for young patients and their caregivers to improve understanding of what asthma is, teach them how to manage conditions to avoid asthma attacks, and show them how to take medication properly.
Our efforts are paying off. We can now go back to our data and track outcomes for kids from these clinics to see if we’re making a difference. We are able to show that children in the program have fewer ER visits and hospital stays due to asthma attacks, and are missing less school.
Originally a three-year program, we are extending it based on these successes. Further, we are expanding the training program to 10 more Texas clinics. We will also add an “in-home evaluation” component where the American Lung Association of Texas will offer to have an asthma educator visit the homes of children who still have poorly controlled asthma. This helps identify allergens and irritants in homes that may be triggering their asthma.
Originally published 7/1/2016; Revised 2019
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