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Expanding Nationwide Medicaid Asthma Care Coverage

(June 27, 2017)

Asthma is a serious, chronic lung disease that makes breathing difficult for an estimated 24.6 million Americans, which includes over 6 million children. There is no cure for asthma but it can be effectively managed with care that is based on nationally recognized guidelines for diagnosing and managing asthma. The American Lung Association's Asthma Care Coverage Project tracks state-by-state coverage and barriers to this potentially life-saving care to increase awareness about the importance of coverage for guidelines-based care and to help improve the quality of life for the millions with asthma in the Medicaid population.

Asthma can start at any age. It is also the third-leading cause of hospitalizations for children and a leading cause of school absenteeism. Numerous studies show that patients experience better health outcomes, including fewer hospitalizations, fewer days of missed school and lower treatment costs when they adhere to care that is based on nationally recognized guidelines.

Access to guidelines-based asthma care is especially critical for those with Medicaid, as asthma rates are disproportionately high in low-income and minority populations, and low-income children and adults are more likely to be hospitalized for asthma than those with higher incomes. As a result, Medicaid was the most common primary payer for asthma-related hospital stays for both children and adults aged 18 to 44. It is critical that these patients have access to evidence-based best practices in care.

However, despite nationally recognized guidelines, a gap remains between best practices in improving asthma outcomes, and what is actually covered by state Medicaid programs. The  Lung Association has studied these gaps and will use this resource to foster further dialogue between Medicaid and the asthma community to work together to improve asthma health outcomes through increased access to guidelines-based asthma care. The Lung Association's Asthma Care Coverage Project takes a comprehensive approach to track state Medicaid coverage and barriers to access seven different areas of guidelines-based asthma care treatments and services, including medications, medical devices, allergy testing, allergen shots, home visits and interventions and asthma self-management education.

The Lung Association is excited to announce for the first time the availability of information on nationwide state Medicaid coverage and barriers to guidelines-based asthma care across all 50 states, District of Columbia and Puerto Rico. The Lung Association is the only place where people can learn whether or not their state Medicaid population has access to the guidelines-based care they need to treat their asthma. This project represents a unique opportunity for you and your community to educate patients, providers and decision makers about the importance of coverage and access to asthma guidelines-based care in Medicaid to help improve asthma health outcomes.

To learn more about Medicaid coverage of guidelines-based asthma care in your area, please visit our database.

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