Asthma Education Reimbursement by Non-Physician in Missouri

We have been providing home-based asthma education and case management services for high risk patients in West Michigan for almost 15 years.  We have been receiving reimbursement from 5 health plans for these services for the past 12 years and, in fact, that reimbursement amounts to approximately 1/3 (about $190,000) of our annual budget ($550,000).  Best practices for obtaining reimbursement include the following:

• Align employee health benefits with recommended best practices for asthma management, including reimbursements for assessment and monitoring of lung function and symptoms;
• Proactive patient education
• Case management and disease management services where appropriate
• Coverage for children and adolescents of home assessments, services and supplies to reduce environmental triggers
• Employers can also address the high costs of medications by negotiating with insurers for lower charges and helping to offset out-of-pocket costs