title: State-based Medicaid costs for pediatric asthma emergency department visits.
abstract: BACKGROUND
  The prevalence of childhood asthma in the United States increased from 8.7% in 2001 to 9.5% in 2011. This increased prevalence adds to the costs incurred by state Medicaid programs. We provide state-based cost estimates of pediatric asthma emergency department (ED) visits and highlight an opportunity for states to reduce these costs through a recently changed Centers for Medicare and Medicaid Services (CMS) regulation.
  
  
  METHODS
  We used a cross-sectional design across multiple data sets to produce state-based cost estimates for asthma-related ED visits among children younger than 18, where Medicaid/CHIP (Children's Health Insurance Program) was the primary payer.
  
  
  RESULTS
  There were approximately 629,000 ED visits for pediatric asthma for Medicaid/CHIP enrollees, which cost $272 million in 2010. The average cost per visit was $433. Costs ranged from $282,000 in Alaska to more than $25 million in California.
  
  
  CONCLUSIONS
  Costs to states for pediatric asthma ED visits vary widely. Effective January 1, 2014, the CMS rule expanded which type of providers can be reimbursed for providing preventive services to Medicaid/CHIP beneficiaries. This rule change, in combination with existing flexibility for states to define practice setting, allows state Medicaid programs to reimburse for asthma interventions that use nontraditional providers (such as community health workers or certified asthma educators) in a nonclinical setting, as long as the service was initially recommended by a physician or other licensed practitioner. The rule change may help states reduce Medicaid costs of asthma treatment and the severity of pediatric asthma.
authors: Office of the Associate Director for Policy, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop E-02, Atlanta, GA 30329. E-mail: Wpearson@cdc.gov.
authors: William S
authors: WS
authors: Pearson
authors: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Scott A
authors: SA
authors: Goates
authors: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Samantha D
authors: SD
authors: Harrykissoon
authors: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Scott A
authors: SA
authors: Miller
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000191:economics* / Q000628:therapy; D014487:Centers for Medicare and Medicaid Services, U.S.; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000191:economics; D013219:State Government; D014481:United States