While payers have long used telephone-based care management teams to improve outcomes for members with asthma, now they’re also deploying other strategies to fine-tune their outreach to those who are in most need of support, AIS Health reported.
Every member with asthma should have an asthma action plan, says Karen Meyerson, director of commercial care management at Michigan-based Priority Health. Such a plan, which is completed by a patient’s doctor, should include a medication list, tips on recognizing worsening symptoms and steps for responding in an emergency.
Priority Health members can also use a cost-estimator tool to shop for the lowest-cost drugs. For example, members can use the tool to discover a less-expensive generic drug and a pharmacy where their asthma medications cost less.
Nurses and social workers at EmblemHealth conduct home visits to assess the level of dust and mold in asthma patients’ environments, Richard Dal Col, M.D., the insurer’s chief medical officer, tells AIS Health.
To help promote medication adherence, EmblemHealth charges members who use combination inhalers one copay, instead of two. The insurer also allows a 90-day supply for rescue and maintenance medications; depending on their plan design, members may be able to pay one copay, rather than three.
Blue Shield of California members with asthma can receive a home visit by a nurse or a physician. Phillip Baldi, D.O., lead medical care director at the insurer, says while home visits seem expensive, the insurer’s rates with a company providing home visits is comparable to what it pays for an in-person visit to a doctor’s office. “If we can divert five emergency room visits, we can have 50 home visits,” he tells AIS Health.
The insurer is also evaluating offering select maintenance drugs at lower or no copays for members with asthma.