Study Examines Pay for Success Financing Approach for Asthma Interventions

In the June 2018 Edition of the Milbank Quarterly, an article examines “the potential for and challenges of” Pay for Success (PFS) “initiatives that produce savings and/or value for Medicaid.” Researchers “modeled the potential impact of an evidence-based multicomponent childhood asthma intervention among low-income children enrolled in Medicaid in Detroit.” The children were split into three groups: children with an asthma diagnosis, children with an asthma-related emergency department visit in the last year, and children with an asthma-related hospitalization in the last year.

Researchers found “PFS economics of a home-based asthma intervention are most viable if it targets children who have already experienced an expensive episode of asthma-related care.” Researchers concluded “a multicomponent intervention that provides home remediation and medical case management to high risk children with asthma has significant potential for PFS financing in urban Medicaid populations.” They note that there are “significant administrative and payment challenges” associated with PFS, and “without some policy reform and clear guidance from the federal government, the financing burden of PFS outcome payments will be on the state Medicaid program.”

To view the article’s abstract, click here.