A community health worker (CHW)-led home visiting program led to a positive return on investment (ROI) and improved acute and long-term health outcomes for Medicaid-enrolled children with uncontrolled asthma.

Background

CHWs can support children and caretakers with home-based asthma care to support self-management. The Healthy Homes program was established in King County, Washington State, to connect Medicaid-enrolled children with poorly controlled asthma with home visiting services. This study measured differences in symptom management, urgent health care visits, and quality of life amongst children who participated in Healthy Homes, and calculated return on investment from this program.

Findings

Over 370 children were randomized into intervention and control groups. An analysis of baseline and exit interview data showed that children and caregivers in the Healthy Homes group reported more symptom-free days (2.1 more days over a two-week period), fewer urgent health care events (1.3 fewer urgent care visits), and improved quality of life (0.9 points greater on an eight-point scale) than those who were not enrolled in the program. Based on available program and hospital utilization data, Healthy Homes had a $1.90 ROI for every $1 spent on the program.

Policy/Program Takeaways

Interventions like Healthy Homes can improve outcomes for children with chronic conditions and show a positive ROI within the communities served. Similar interventions can be effective to address unmet health-related social needs and poor health outcomes in various care settings.