Wonderful presentation. I am wondering whether in determing health outcomes whether you were able to account for reductions in ER visits, hospitalizations, etc. that are likely to occur just over time rather than due to the intervention. For example, perhaps someone was enrolled because they had just had a severe asthma exacerbation and in six months time they may not have been expected to have another incident that serious.

I'm hoping to hear more information about how exactly any Community Health Workers were funded using Medicaid dollars. On the call the presenter from Oregon mentioned that billing rates were established which suggests fee for service. I'd appreciate hearing more details. For example: 

-- On a fee for service basis, did the CHW program bill the state and/or did it bill managed care organizations? 

-- Do managed care organizations provide CHW services as part of the managed care funding they receive from the states (i.e., non-fee for service)? 

Pre/post evaluation designs of asthma interventions are weak since absent any intevention, utilization decreases over time due to regression to mean. Convincing (at least to researchers) studies require a control group. Are the pre/post data sufficient to convince plans, medicaid officials, etc. of the value proposition?