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Researchers at The George Washington University Department of Health Policy conducted an exhaustive review of the nation's data collection framework for childhood asthma and identified both barriers and opportunities to improve the quality of care for children with asthma. In this brief, authors put forth recommendations for standardizing surveillance measures and expanding existing reporting functions and systems to improve data collection on children with asthma.

This brief focuses on how the medical home model facilitates comprehensive, patient-centered care by fostering partnerships among and between patients and their providers, including primary care doctors, specialists and emergency service providers. The Patient Protection and Affordable Care Act (PPACA) established the patient-centered medical home as a matter of policy and promotes reforms to support the creation of medical homes for patients with chronic illnesses, including asthma. This brief reviews the key PPACA provisions that advance the medical home concept in public and private health insurance and recommends ways the U.S. Department of Health and Human Services (HHS) can fully utilize the medical home to advance high-quality treatment and effective childhood asthma management.

Changing pO₂licy: The Elements for Improving Childhood Asthma Outcomes was authored in 2010 by health policy researchers at The George Washington University (GW) School of Public Health and Health Services. The report was funded by the Merck Childhood Asthma Network and the RCHN Community Health Foundation. 

GW identified five essential elements that are key to improving asthma outcomes and provided practical and evidence-based recommendations about how to bring these elements to life to improve childhood asthma outcomes: 

1.Stable and continuous health insurance

− Make continuous Medicaid and CHIP enrollment a part of every eligible child’s asthma treatment plan developed by the child’s health care provider team.

− Encourage all states to expand Medicaid and CHIP to at least 300 percent of the federal poverty level and to adopt new options to fully cover legally resident children.

− Encourage all states to adopt Medicaid and CHIP enrollment and retention reforms, especially reforms aimed at making enrollment and retention activities possible through community health care providers, schools, and other locations where children and families can easily apply for and renew coverage.

− Make enhanced asthma treatment and management a specific focus of quality performance improvement in Medicaid and CHIP.

2. Provide high quality clinical care and case management for children whose asthma is hard to manage or control, and reach all children regardless of whether they have health insurance coverage

- Create an HHS-led, cross-agency, Administration-wide national plan for changing childhood asthma outcomes, involving: CMS, HRSA, CDC, IHS, ONCHIT, ED, HUD and EPA.

- Make performance improvement in childhood asthma a key program aim for community health centers and the Indian Health Service, which together are health care homes for over 7.5 million of the nation’s most at risk children.

3. Continuous information exchange and monitoring, using heath information technology (HIT) as much as possible

- Enhance asthma monitoring through model registries and target use of comprehensive integrated HIT systems to promote clinical reporting as well as coordination and communication among care providers, public health agencies and schools.

4. Asthma trigger reduction in homes and communities

- Encourage public health agencies, housing authorities and environmental agencies to promote evidence-based interventions and services that are essential to reducing the many environmental asthma triggers that lie beyond the control of any one family and fall outside of traditional “health care” interventions.

5. Learning what works and increasing knowledge

- Promote a strengthened and diversified Administration-wide research agenda to include basic, clinical and translational/ implementation investigations.