Healthcare Systems and Financing - National Asthma Public Policy Agenda

Supporting Strategies:

• Maintain and expand access to Medicaid, CHIP, and other affordable health insurance coverage options for eligible populations.
• Ensure that Medicaid and other payers include all asthma treatments and home-based asthma services that reduce or eliminate environmental asthma triggers recommended by national evidence-based guidelines in coverage policies.
• End policies that require patients to change medications when they are already well controlled (non-medical switching) and other practices that interfere with patients’ ability to control their asthma. 
• Limit out of pocket costs for patients to support adherence to medications and other treatments.

Supporting Strategies:

• Implement activities such as those outlined in CDC’s EXHALE Guide for Medicaid and Children’s Health Insurance Program (CHIP) Leaders or CDC’s EXHALE Guide for Managed Care Leaders and Staff.
• Ensure that prescription formularies include a full range of medication options for quick-relief and long-term control of asthma in accordance with the National Asthma Education and Prevention Program (NAEPP) guidelines for diagnosing and managing asthma.
• Develop and test innovative payment models that incentivize providers and cover treatments and services to support the needs of people with asthma.
• Develop and implement coding, coverage and reimbursement policies for payment for home-based asthma services, including environmental remediation.  
• Develop and implement sustainable financing mechanisms to better integrate services provided by community health workers into the healthcare delivery system.
• Expand access to telehealth services.

Supporting Strategies:

• Implement the activities outlined in CDC’s EXHALE Guide for Healthcare Professionals. 
• Provide self-management education using evidence-based interventions by trained professionals as a standard of care.
• Develop and use asthma action plans for all patients.
• Provide case management and care coordination, including home-based asthma education, environmental assessment, remediation, and referrals to other social supports or resources, for high-risk patients and those whose asthma is not well controlled.
• Provide tobacco dependence treatment and pharmacological therapy to smokers who have asthma or who have family members with asthma.
• Recruit and train a diverse workforce to care for patients with asthma, including community health workers (CHW), pharmacists and other members of patients’ care teams.

Supporting Strategies:

• Implement the activities outlined in CDC’s EXHALE Guide for Healthcare System Executive Leaders.
• Revise, expand or develop national performance measures aligned with national standards to better measure asthma control and quality of care.
• Provide comprehensive and consistent data that is reported across healthcare systems, including through electronic health records, to improve asthma surveillance and tracking of asthma outcomes and disparities.