While payers have long used telephonic-based care management teams to improve outcomes for members with asthma, more recently, they’re also deploying algorithms to fine-tune their outreach to members who are in most need of support. Those algorithms incorporate data such as asthma-related emergency room visits and hospitalizations, first-time prescriptions for asthma medications, additional comorbidities and frequent refills for albuterol inhalers, which suggests that members’ asthma isn’t well managed using long-term control medications.
According to the Centers for Disease Control and Prevention, 7.7% of adults and 7.5% of children in the United States have asthma. Forty-five percent of working adults had an asthma attack between 2011 and 2016, whereas 10% visited the ER due to an asthma-related emergency, per the federal agency. Asthma is the cause of 1.6 million ER visits each year. The average cost of an ER visit to treat asthma is $1,502, according to a 2014 study.