The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts


Chelmer Barrow1, George L. Oestreich2; 1APS Healthcare, Jefferson City, MO; 2MO HealthNet Division, Jefferson City, MO

Background-The combined rate of asthma and COPD in the Missouri Medicaid population is over 15% and accounts for over $1.8 million annually in direct healthcare expenditures. Although strong evidence exists for treatment of these diseases, there are significant barriers to care and compliance within low income populations. In 2007, the Missouri Medicaid program (MO HealthNet) launched a program to provide care coordination and disease management to fragile participants with chronic disease, including asthma and COPD. Enrolled members received interventions which included helping patients find stable primary care or specialty providers and securing appointments; facilitating transportation to office visits and pharmacies; placing medication reminder calls and education on avoiding disease-specific triggers, etc. Interventions were provided over the phone and within community settings by registered nurses. Method-Claims and pharmacy data from October 2008 to September 2009 were analyzed, comparing 26,525 MO HealthNet members with COPD who were continuously enrolled in the care management program to 22,170 members with COPD who were not enrolled. In addition, 37,350 members with asthma who were continuously enrolled in the care management program were compared to 52,761 members with asthma who were not enrolled. Compliance with two key evidence-based metrics, defined as one or more prescriptions filled during the measurement period, was compared among the enrolled and non-enrolled groups. The enrolled group was further divided into those enrolled one to eleven months and those enrolled at least 12 continuous months. Results-Members with COPD enrolled in the care coordination program for 1-11 months received recommended treatment with bronchodilator medications 58% of the time, compared to 39% in the non-enrolled group. Members enrolled in the program for 12+ months had a 66% compliance rate. Similarly, enrollees with asthma received recommended treatment with inhaled corticosteroids 30% and 40% of the time (for the 1-11 and 12+ month groups) compared to 28% compliance of non-enrolled members. Results for all cohorts were statistically significant: (p = < 0.01). Conclusion-Enrollment of low income, medically disabled members with respiratory disease into a care coordination program significantly increased rates of medication adherence for individuals with COPD and asthma. Compliance rates increased when individuals were enrolled for longer periods of time. Sponsored Research - None