Implementing a community health worker (CHW) program led to approximately $567 in savings per pediatric Medicaid member with uncontrolled asthma.

Background

There is a strong evidence base supporting the positive impacts of CHW programs on pediatric asthma outcomes, such as more symptom-free days and improved home environmental conditions. Massachusetts’ 2023 MassHealth (Medicaid) 1115 demonstration waiver established new pathways to fund innovative service delivery models, including CHW home-visiting programs for children with asthma. This study estimated potential cost savings of implementing a CHW-led home visiting program for MassHealth-enrolled children with uncontrolled asthma.

Findings                                                                                  

Using past claims data to calculate projected savings, the study estimated asthma-related savings from implementing the program to be approximately $567 per patient, with a total estimated savings of $775,000 for approximately 1,400 children over a one-year period. Savings reflect reduced costs for asthma-related emergency department visits and hospitalizations.

Key Takeaways

CHW home visiting programs that address pediatric asthma have been shown to improve related health outcomes, and this study highlights the potential savings Medicaid programs can expect to achieve by implanting these programs.