title: Children's hospital boston community Asthma initiative: partnerships and outcomes advance policy change.
abstract: OBJECTIVE
  Rates of poorly controlled asthma among low-income children, particularly racial and ethnic minorities, remain disproportionately high. Comprehensive asthma programs, including education, case management and home environmental interventions have reduced disparities. Few sustainable payment models exist.
  
  
  OBJECTIVE
  The Children's Hospital Boston's Community Asthma Initiative (CAI) demonstrated dramatic reductions in hospitalizations and emergency department (ED) visits among African American and Latino patients with a return on investment (ROI) of 1.46. A strong coalition focused on sustainability plus CAI outcomes contributed to the state legislature's approving a bundled payment pilot for high-risk pediatric asthma patients on Medicaid/MassHealth.
  
  
  CONCLUSIONS
  Cost-effective, comprehensive asthma programs and policy makers' interest in new payment models created an opportunity for a new payment approach for pediatric asthma care.
  
  
  CONCLUSIONS
  A community coalition that successfully addresses asthma health disparities with a strong business case and program outcomes can be leveraged to persuade policy makers of the value of innovative financing strategies for asthma care.
authors.affiliation: Division of Adolescent/Young Adult Medicine, Children's Hospital Boston, USA.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Sommer
authors.forename: Lisa Mannix
authors.initials: LM
authors.lastname: Queenin
authors.forename: Shari
authors.initials: S
authors.lastname: Nethersole
authors.forename: Joshua
authors.initials: J
authors.lastname: Greenberg
authors.forename: Urmi
authors.initials: U
authors.lastname: Bhaumik
authors.forename: Laurie
authors.initials: L
authors.lastname: Stillman
authors.forename: Polly
authors.initials: P
authors.lastname: Hoppin
authors.forename: Elaine
authors.initials: E
authors.lastname: Chan
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Wilkinson
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Woods
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D001249:Asthma / Q000191:economics / Q000208:ethnology* / Q000628:therapy; D001900:Boston / Q000453:epidemiology; D019090:Case Management; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D006265:Health Care Coalitions; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric / Q000191:economics / Q000639:trends*; D006801:Humans; D008484:Medicaid; D010344:Patient Advocacy; D010353:Patient Education as Topic; D010865:Pilot Projects; D011203:Poverty; D014481:United States