By Adem Lewis / in , , /


Chris Regal: Good afternoon everyone and welcome
to Components of a Winning Program, Health Plans’ Perspectives on EPA’s National Environmental
Leadership Award, a webinar hosted by America’s Health Insurance Plans in conjunction with
the U.S. Environmental Protection Agency. I’d like to thank everyone for
joining us today. My name is Chris Regal and I’m a senior
health research associate with AHIP and I will be monitoring—moderating
today’s discussion. Next slide, please. Before we begin, I just want to highlight
a few housekeeping notes. We ask that all attendees please place
your phone lines on mute for this webinar. We will also be using a chat feature
in the webinar for questions. Questions will be addressed
throughout the webinar as well as
at the end of the presentation. Polling questions will be conducted
during the webinar, and we ask that
you please participate. And finally, slides will be posted after
the webinar at ahip.org/asthma where you can find other
asthma-related resources and past webinars. Next slide, please. Today’s webinar is about the health plan
perspective on the EPA’s National Environmental Leadership Award. We want to provide webinar participants with
information on the application and the process, and we want to educate participants
on the value of the award. We will also discuss challenges
to applying for the award and offer recommendations for
addressing these challenges. Finally, we want this webinar to serve as
a resource for anyone interested in applying for the award. Next slide, please. We also want to call attention to
a brand new series of videos that AHIP has produced
as part of the asthma project. These three videos we produced will cover—
or rather cover the value of the EPA award featuring health plans and
community organizations discussing how the award has helped them gain
national recognition of their program. The second video is a discussion of asthma
management programs coming from those who have established and implemented them,
with talk of sustainability. And the third video discusses the value
of partnerships and collaborations across health plans
and community partners. These videos will be shared on ahip.org/asthma,
and a link to the award-specific video will be provided in the chat function today. Next slide, please. So as mentioned, we have
some polling questions today. And the first question is “Which option best
describes your organization?” So as you can see from our early results,
about a third of our participants are health insurance plans. We appreciate you joining us. And we also have representation from
private companies other than health plans, about 20 percent in community-based organizations,
15 percent government agencies, and a quarter of our attendees are “other.” Thank you for responding. Our second poll question is “If you are not
a health insurance plan, does your organization currently partner with any health plans to
deliver asthma management services?” So about a third of those who responded,
30 percent, indicated that they do work with health plans for asthma management services,
and 22 percent of those who don’t say that they’re interested. I think those are really great numbers,
especially for this audience. Our third polling question is
“Where did you learn about the EPA Leadership in
Environmental Asthma Management Award?” The majority of our participants
came from e-mail notification or the asthmacommunitynetwork.org,
which is great. We have 8 percent from the ahip.org/asthma,
and 4 percent from the EPA, and about one in five
came from another source. And finally, most specific to this webinar,
“Does your organization plan to apply for the award?” Great, great. We have about 21 percent saying they will,
and about 60 percent that aren’t sure. Excuse me. And for those who aren’t sure,
hopefully this presentation will help clear up some questions and encourage you
to apply for the award. It has some great, great benefits. And thank you all for your responses. Next slide, please. Our first speaker today is Tracey Mitchell
of the EPA’s Indoor Environments Division to tell us about the National Environmental
Leadership Award in Asthma Management. Tracey Mitchell: Good afternoon, everyone. Thanks, Chris. I’d like to start by saying a thank you to
Chris and his colleagues at AHIP for the work that they’re doing to promote and
support the best practices across comprehensive asthma management through
health plans and other organizations. I’m pleased to be here on behalf of
EPA to tell you about this national recognition program
and to encourage you to apply. I’d like to give a special thank you to
Karen Meyerson and Karen Michael, the two speakers you’re going to hear from. I really appreciate their willingness to share
their perspectives as previous award winners and for their eagerness to impart the knowledge
and experience regarding their asthma programs. They have a lot of really great information
to share. Next slide. Before we get into the meat of the presentations,
I want to start by giving you just a little bit of background on the
National Environmental Leadership Award. EPA started this award in 2005, and since then
we have continued to surface best practices by awarding, in three categories, 38 awardees. The three categories are health plans,
healthcare providers and communities in action. Today, we’re focused on the—our two
winners will focus on the health plan category, but as we see from the variety of stakeholders
who are on the call, we all realize it takes coordination and cooperation
from many partners and organizations to deliver comprehensive asthma care,
hence the three categories. And many of the categories, even though
a health plan is the primary recipient, often they’re partnering with
a community organization, or a healthcare provider is
being reimbursed by a health plan. So as you see, there’s a lot of overlap
in these categories, but we’re excited to focus
on health plans today. Next slide, please. Today we will hear from AmeriHealth Caritas
and Priority Health, who are among several of our health plan winners, and you see
the previous recipients on the screen right now. They represent plans from across the country,
they represent different sized plans, and they represent different programs that have
different approaches but share a common goal of supporting the delivery and sustainability of
asthma care that realizes cost savings and achieves positive health outcomes. Next slide, please. So these programs have demonstrated what it
takes to win the award and, as you see, these are some of the key components to winning
the National Environmental Leadership Award. If your program embodies a system for delivering
high quality asthma care that includes what we’ve identified as five key drivers
of care, and this includes having strong community ties, having committed leaders and champions,
working with high-performing collaboration, serving and delivering integrated healthcare
services, and of course having tailored environmental interventions
as a key component. Also, if your program is grounded in science,
in the NAPP guidelines, which also include a robust environmental component in those
national guidelines. Ultimately, we’re looking for programs who are achieving health outcomes
and return on investment or financial savings. Next slide, please. So again, if you decide whether to apply for
this national recognition, consider the components of your program that address the application
criteria and especially demonstrate success in improving health outcomes
and the bottom line. Your application will be reviewed by two panels
of experts including asthma champions from EPA, CDC—the Centers for Disease Control—
National Institutes of Health, HUD—Housing and Urban Development—
nonprofit organizations, and previous winners. These panels of experts review each application
based on the criteria and make the recommendation for this year’s winners. Next slide, please. If chosen as an award winner, you’ll be highlighted
and placed in our Hall of Fame. This is on Asthma Community Network.
This is where we feature the 38 previous award winners, and you would join this
distinguished group of programs. Each program receives an engraved crystal
to display in your organization. The announcement of the award winners and
promotion of your program typically takes place—and we’re planning to announce in
May during Asthma Awareness Month. We use that as a great venue for
getting aware—for raising awareness and for getting visibility for
the—our award winners. Recognition on Asthma Community Network,
on EPA’s website, as well as through media and press kits, and an opportunity to share
your program successes through webinars like this, through speaking at national conferences,
and by serving as mentors to other programs across the country. These are all benefits that
come with winning the award. So now let’s hear from today’s speakers
with more details about their programs and what it takes to win the award. I’ll turn it back over to Chris. Chris Regal: Great. Thank you, Tracey. Our next speaker, as you can see
on the screen, is Karen Meyerson, the director of commercial care management for Priority Health. Priority Health is the recipient of
the leadership award in 2007, and Karen can provide some insight into their
winning program and the value of the award. So take it away, Karen. Karen Meyerson: Great. Thank you, Chris. And good afternoon, everyone, and
thank you for this opportunity to talk about Priority Health and the national award that was won
10 years ago now. It seems amazing, but I’m delighted
to talk about that. This is our contact information. And I want to just to provide a little bit
of background as well. When we go through the slides,
I came to Priority Health 4 months ago after serving 20 years as the manager of the
Asthma Network of West Michigan, which won a— the national leadership award on the provider side of it. So using both perspectives, I would like to
address this now, that Priority Health approaches healthcare differently. While most insurance companies focus on
processing claims, which is what we do as well, we also work closely with our customers
to ensure that they receive the right care at the right time in the right place. And we were created 30 years ago by a group
of physicians and hospitals who wanted to ensure that the community they serve
could afford access to quality care. So we are a nonprofit health plan. We operate efficiently
on behalf of our customers. We spend 90 cents of every dollar on our customers’
medical care, and there aren’t many health plans that can say that,
so we’re very proud of that fact. We’re leading the industry with our work
to pull back the curtain on healthcare costs with one-of-a-kind tools that help our customers
shop for care. One of those examples is our
transparency tool, where members can go online to the member portal,
they can search for green facilities. And in this case, with all respect to the EPA,
green facilities in our case mean lowest cost facilities and not necessarily
environmentally friendly facilities, but they can find these green facilities
for the most commonly searched procedures. And if they choose a green facility,
then they are given a rewards card. They can also go online and look at what their
out-of-pocket costs will be for anything from prescriptions to procedures as well, and they
can determine where they want to receive care. So these transparency tools are
fairly new and innovative. We cover 750,000 lives. We are a regional plan, so in the state of Michigan. We have all three products, commercial,
Medicare and Medicaid. Commercial is our largest book of business,
about 500,000 covered lives. Of those, about 100,000 are individuals who
have purchased our healthcare through the Affordable Care Act. Medicare and Medicaid just about split
the difference of the other 250,000 covered lives. Next slide, please. So our hard work is being recognized. We have a long history of providing progressive
products from our programs. We want to keep our healthcare costs down and
provide the best care possible to our community and keep our community healthy. We’ve been named among the nation’s
best health plans by the NCQA. We were the first in the industry to reward
physicians for quality care, through our physician improvement incentive. We lead the industry in revealing
healthcare costs. I mentioned the transparency tool, among others. And 9 out of 10 people would recommend
Priority Health to their family or friends. So from the myriad of health and chronic disease
management support that we provide, our team, to our customers, to the wealth of resources
that we provide to our community, we are striving to improve the health and the lives of the
communities in which we live and we work. Next slide, please. So our successful collaboration goes back
to the Asthma Network of West Michigan and that is the grassroots asthma coalition that
I helped develop and managed for 20 years. The Asthma Network of West Michigan began
in 1996, and after 3 years of successful home-based case management, approached
Priority Health and asked them if they would be interested at that time in reimbursing the Asthma Network
for those services. So in 1999, Priority Health partnered with the
Asthma Network of West Michigan, developed a contract, and it was the first-ever
contract between a health plan and a grassroots asthma coalition
in the nation. And we’ve been paying the Asthma Network
ever since for those services, and this partnership underscores the value of the Asthma Network
services and Priority Health’s commitment to its members. So Priority Health reimburses the Asthma Network
for home-based asthma case management to Priority Health members with asthma, both
Medicaid as well as commercial and now even Medicare members with COPD or
asthma as well. The reimbursement is for services that are
provided by nurses at the RN level or respiratory therapists at the RRT level or
licensed masters level social workers. All of them are certified asthma educators,
or they must become certified asthma educators within a year of employment, and they
provide home visits for these individuals in three West Michigan counties. They visit the families, they follow them
for anywhere from 3 to 6 to 9 months, sometimes up to a year depending on the acuity and the
degree of severity of asthma and other comorbid conditions, as well as social determinants
of health. The care managers really provide a holistic
approach where they identify not only asthma itself and triggers that might be affecting
that individual but also other competing priorities that might impact that family’s ability
to optimally manage asthma. So the care managers also go into the schools
and conduct a school visit so they ensure that the school staff know how
to manage asthma in that setting and have an asthma action plan on hand,
know how to use the inhalers. They also accompany the families to care conferences,
with obviously permission of the provider and the family, just to listen in, and they’re
also able to reinforce those messages that the families are hearing during these asthma
visits. All of these types of visits are reimbursed
by Priority Health, and the reimbursement for home-based case management has been able
to show—demonstrate ROI, return of investment, as well as value on investment. Next slide, please. So the national leadership award which was awarded,
as I said, was in 19—I’m sorry, 2007, which was now 10 years ago, and the
Asthma Network won the award in the provider side the very next year in 2008. But those awards have been able to elevate
both organizations. That is the opportunity to really promote
this innovation that is taking place in chronic disease management
such as asthma. It allows us to share our risk stratification,
how we utilize and leverage community partnerships. We also demonstrate and are able to share
some clinical and financial outcomes, as well as our payment strategies. We were able to obtain this national recognition
by the U.S. EPA. And we also do a considerable amount of networking,
not only on the provider side, could be Asthma Network, but also on the payer side
with other communities around the nation that are doing similar types of work. And EPA has been very successful in mobilizing
1,000 communities who are working for individuals who have asthma. It has also been a springboard for greater
visibility in asthma management best practices and it’s been an impetus for other
program development such as COPD. Since Priority Health approached the Asthma
Network about 2 to 3 years ago and said, “You know, we love what you’re doing for
our members with asthma, we know that members who have COPD would also benefit from this
in-home case management, education, support, holistic approach. Would you consider adapting your program and
serve our members with COPD as well?” So the Asthma Network took that
under advisement and then created a COPD in-home case management model
predicated on the asthma model. I tweaked it a bit. The staff members continued to receive
training in COPD and COPD management and there’s no national certification
for that, but there are several courses for COPD educators,
and they have been able to provide these services and bring great value to our members
with COPD as well. Next slide. Thank you very much for your time and attention. Be happy to answer any questions you have. Chris Regal: Great. Thank you, Karen. That was great. Our next speaker up is Karen Michael, the
Vice President of Corporate Medical Management for AmeriHealth Caritas, which won
the 2016 leadership award. Karen, go ahead. Karen Michael: Thank you, Chris. AmeriHealth Caritas serves over 5.3 million
members, and the majority of those are in managed Medicaid health plan business. We also have two Medicare D-SNP plans, two
eligible special needs and two Medicare Medicaid demonstration programs in addition to our
wholly owned pharmacy benefit management and behavioral health managed care companies. Our Medicaid health plans operate in six states
and the District of Columbia, and among that population, asthma is definitely
the highest volume chronic condition that we see in our members. We’re going to go to the next slide, Chris. The main key to our program is that there’s
really no one initiative or approach that we have found to be effective. The results that we—and program components
that we pulled into our comprehensive approach to asthma were largely piloted in our Philadelphia
market, where we’ve got a high incidence of asthma, and with the poverty and the living
conditions in some of the residences in Philadelphia, a lot of environmental triggers that exacerbate
and hinder a family’s ability to control a child’s asthma. So we really took a very continuum-based
approach, going across the community, schools, provider offices, and then also
involving the enterprise in setting goals. On the community front, we partner with
community health workers. We both partner and employee
community health workers. So depending on the organization that we’re
working with, some of the provider offices, we actually fund the position for them. In other offices, we provide the actual FTE
resource in the office to do home visits and followup for our members with asthma
that are seen in that office. As part of that home environmental assessment,
we’re able to provide remediation kits, mattress covers, disinfectants that can help
families who are—have an asthmatic child in the home, as well as get a whole picture
of the different triggers that might be present in the home and not discussed in the physician’s
office. So finding out about the secondhand smoke,
about the two cats that are kept in the bedroom next door. We also work in the schools with the school-based
clinics and changed some of our policies to support our asthma work, including the policy
around inhaler refills, making sure that children have the ability to get two inhalers so that
they can keep one at school and one at home. On the community front, we hold asthma edutainment
programs. And the most notable of those is our
Healthy Hoops program, which combines asthma education with a basketball clinic. We bring in local celebrities to provide
clinic drills and basketball technique education while we’re concomitantly providing education
to those children around the importance of maintaining their controller medication, how
to exercise and still keep your asthma controlled, working with families in separate clinics
and workshops during that daylong program to provide them with education on action plans
and triggers. Every child coming through gets a complete
assessment, including pulmonary function testing and, if necessary, referral to
a physician on site. They all leave with an asthma action plan
that’s either developed in conjunction with their current physician or developed on-site
for them to bring and discuss with their physician in a followup appointment. In the provider offices, one of the things
that we found is a limiting factor was the disconnect that happened when a child was
started on asthma medication or inhaler or needed equipment to more effectively use the
inhaler and had to leave and go to a pharmacy and maybe they got some instruction in the
office on what to do, but it wasn’t on their inhaler and their equipment. So when they got the equipment
from the pharmacy, they often had to come back for
additional instruction. We provided dispensing cabinets for asthma
medication in physician offices so that the physician could dispense the medication and
the spacer or whatever other equipment was needed right there and provide that education
before the child left the office. And then the other piece that I really want
to emphasize was the focus that the organization put on asthma as a whole. Since 2013, we have had an annual enterprise
goal that has focused on one or more aspects of asthma management. The first year, we started focusing on
what we call failure events, which were an admission for diagnosis of asthma. So looking at conditions like asthma that
could be managed in the community and could be managed in an ambulatory setting,
that should not result in an admission where the primary driver of
that admission is exacerbation. We also looked at medication adherence
among our asthmatic population and set an enterprise goal the following year
to increase medication adherence. We looked at readmission rates for our members
with asthma in the third year. So every year we picked a different element
to focus on as an organization and to come up with a—and put plans in place
to enhance our current program to impact that particular
goal for the year. Go to the next slide. When we first started looking at this award,
we weren’t sure that we were equipped to apply for it, and I’ll be upfront
with you about that. But we took a step back and looked at everything
we were doing and how—and pulled together the resources across the organization from
our community education, our public affairs department, our provider network area,
our regional chief medical officers, and when we pulled everything together
and took a look at the body of work in total, we did believe that we had enough
to be successful, and as you can see, we were successful
in winning the award. And the award has helped us as an organization,
not only from the outside recognition and being able to share that information with our
potential or renewing customers, but also internally because it gives the staff validation
that what we’re doing to impact the lives of our members, to help them get care, stay well
and build healthy communities, is not just something that we do because we know
it’s the right thing to do but that there’s external validation that this is
making a difference for people. Since we’ve won the award, we have continued
to scale out our parent programs, take components of them and bring them to other markets. So our best initiative, which involves the
provider office dispensing for the asthma medications and equipment,
has now expanded to two other markets within our family of companies. Our community health worker programs
likewise have expanded across our different health plans in the country. We were also fortunate to participate
in AHIP’s leadership roundtable as one of the external recognitions
of winning the award. Next slide, please. Chris Regal: Thank you very much, Karen. Karen Michael: I’d be happy to take any
questions as well. Chris Regal: Good. Thank you, Karen. I also just want to point out that
roundtable report that Karen referenced can be found right on the front page at
ahip.org/asthma. It was a really good report, I thought, and
hopefully you can read it and gain some insight into the plans who spoke today, as well as
some of the other plans. Now we will go back to Tracey Mitchell for
some more information on—from the EPA. Tracey Mitchell: Great. Thank you, Chris. And I’ll just say thanks again to Karen
and Karen. I think they both are great at describing
their programs. And you hear from one program who won 10 years
ago, they’ve been able to sustain their program over time and been able
to use this award to, as Karen said, develop and begin work in another disease entity,
COPD, and model similar components of their asthma program. So it’s really exciting to hear how they
have evolved and used this award to enhance their program and start a new program. And then you hear from Karen Michael who,
you know, is a more previous winner, just last year, more recent winner,
I should say, and how they’ve been able to leverage the award again to expand
and to, I heard her say, expand into two other markets and to really promote the work
that they’re doing throughout their organization. So this is very exciting. We look forward to hearing from Karen Michael
in 10 years as their program evolves over time. So as you see on the slide, hopefully what
you heard from both of these programs excites you about applying and helps you think
about how you could tell your story. If you need help though, there are resources
to help, and we want to help you. There are sample applications on the website
for the award. So specifically here’s a link to the
health plan application, but again, there’s a sample for the community category
as well as the healthcare provider category. I really want to encourage you, if you’re
considering applying, to visit the Hall of Fame on
asthmacommunitynetwork.org. This is where you’ll be able to read about
all of the previous award winners and kind of see in a snapshot the components
of their program, what made them award winners. Again, the award is over 10 years old,
so programs have evolved, the award has evolved a little bit,
but the primary and kind of the key components haven’t changed. So you’ll be able to see those key components
reflected in all of our previous award winners. I mentioned again the Change Package, the
five key components, high-performing collaboration, champions and leaders. Those are kind of elaborated on and
spelled out in our Asthma Change Package. You have the link there. And again, everything that we do
and all of the science around asthma is grounded in the NIH’s
NAPP national guidelines. So there’s a link there for your reference
in case you need that as a reference. Next slide, please. We’re going to take some questions. But before we do that, based on
what you heard, after participating and hearing from our two speakers,
does your organization—does this change your mind
about applying for the award? So about a quarter of you, sounds like
you heard things that make you more apt to apply. Over half of you are still not sure. So hopefully we have some questions that
have come in through the chat function. We’ll go ahead and answer some questions. You have my number and e-mail that
was given at the top of the presentation. You have Chris’s information. Any of us are able to answer questions. We can’t answer specifics about the, you
know, your program in the application but we’ll try to give you as much information
and as much help as we can so that you’ll—you can decide if it’s a good fit for
your organization and whether or not to apply. Chris, I think if you want to go ahead
and start addressing some of the questions you’ve received. Chris Regal: Sure. Actually, right before we do that, I just
want to let everybody know that the deadline for applications is 11:59 p.m.
on February 1. So if you plan on applying, please get your
applications in before then. And yes, let’s answer some questions from
the audience. So first question was asked—was to either
or both of our speakers. “What made you decide to apply
for the award, and how did you know your health plan was ready or qualified?” Karen Michael: Hi. This is Karen Michael. So anyway, so we had looked at it the year
prior and, you know, as we were—I think a little bit too late looking at it
that year so we really weren’t able to pull enough together, but we set out
to make sure we would be ready
for the next application cycle. And we knew we were ready when we
were able to map all of our current program components to the different pieces that were in the application
with respect to community involvement, partnerships, working across the continuum of care,
having an integrated care management approach. So really we used the application
to help us more or less as a checklist to understand whether or not we had
what it would take to apply for the award. Karen Meyerson: And this is Karen Meyerson. And this goes back again 10, probably 11 years,
when I was with the Asthma Network, which won in 2006 a model program award as a result
of our collaboration with Priority Health and that elevated both
of the organizations. And as a result of that, Priority Health
did apply in 2007. Because of that unique, innovative relationship
where they pay—they were the first payer in the nation to reimburse for those home-based
case management services. It had never happened before
as far as we are aware. And because of that, the Asthma Network
has been able to engage in contracts with four other health plans. So it really has enabled the Asthma Network
to be sustained for 20 years, and Priority Health has seen tremendous benefits
from that collaboration as well. Chris Regal: Great. Thank you very much. This question is specific for—I believe
Karen Michael said it. “You mentioned offering disinfectants
to clients during your home visits. What type of disinfects—excuse me,
disinfectants do you provide?” Karen Michael: They are—it’s a part
of an asthma control kit and truthfully, if you send me an e-mail, I’d be happy
to find out the answer and I just don’t know it off
the top of my head. I have to go to look at the … Chris Regal: Great. Karen Michael: … contents of the kit. Chris Regal: Thank you. Another question from the forum is “Can
a community health worker be reimbursed for home visits in Massachusetts? Are there resources to find this state-by-state?” I can actually answer this one. There are resources available on asthmacommunitynetwork.org,
and these are constantly being updated. So I would direct you to the Network
“Financing In-Home Asthma Care” page for resources on their state website. Next up, “Is the award eligible
for Canadian companies?” Tracey, I will throw that one to you. Tracey Mitchell: Okay, great. Thank you. Unfortunately, no. On the on eligible—eligibility page of
the award, it goes specifically who’s eligible and unfortunately, folks out of the country,
out of the United States are not eligible to apply at this time. Chris Regal: Great. And Tracey, sticking with some more
application-specific questions. “Can school districts apply,
and can for-profit groups apply?” Tracey Mitchell: Good question. Yes. School districts can apply. Again, look at the criteria, and if you have
an asthma management program that’s either district-wide or, you know, involves several
schools, absolutely you would be eligible. For-profit, many health plans are for-profit
entities and so yes, they would be eligible to apply as well. Chris Regal: Great. Another question came in from the audience. “Many health plans are very large and at the
national or regional level, but the asthma programs are often
specific to a state or community. How do you recommend we best describe
the relationship in the application? Should we focus on the larger scale
or on the smaller components specific to the asthma program?” Tracey being the application expert,
that may be for you. Tracey Mitchell: Well, actually, I’d
like to punt it to Karen Michael first … Chris Regal: Sure. Tracey Mitchell: Yes, because she,
you know, is a great example. Her health plan covers six states
and has many different components. And so if she wouldn’t mind taking this
and then I’ll jump in afterward. Karen Michael: No, not at all, but Chris,
just read this to me one more time. Chris Regal: Sure, sure. So in the application process, this questioner
is curious if they should focus on the larger scale or on the smaller scale components
specific to an asthma program when they have a large and/or national program. Karen Michael: We actually use
a combination of both. So we’ve got some components of the program
that we included in the application that are very large-scale, like our, you know,
data mining and care gaps and outreach for asthma medication refill,
and some that are very small-scale, such as the home visit component
and the community health worker piece. So I would actually encourage you
to present it as a balanced portfolio because it’s really about making sure
that members in—with different needs are getting services that
meet those particular needs. So describing the intervention, the population
it’s targeting, and then the impact that intervention had for both sets of interventions,
large-scale and small-scale, I think is helpful. Chris Regal: Right. Karen Michael: And I’m not the reviewer
of the application. Chris Regal: Sure. Karen Meyerson: And this Karen Meyerson. And with Priority Health, while there are
pockets of reimbursement throughout the state, Priority Health reimburses Asthma Network,
obviously, and West Michigan, but there’s also a robust team of telephonic care managers
who serve members throughout the state. So they are doing care management for individuals
with asthma throughout the state and in their—when there are areas
where there are home-based components, it is a very closely tied team where
the individuals go into the home
and provide those services, and when that family graduates or
when that case is closed, then there’s a warm handoff
to the telephonic care managers. So I would agree. I would do
both larger and smaller scale. Chris Regal: Great, great. And another question just to both speakers
is “If you had one piece of advice for tackling the application, what would it be?” Karen Michael: Again, this is Karen. I would say really just making sure that you
very clearly map what the application is asking for through the answer and text you’re providing
because the space is a little limited. So you want to make sure that you’re making
your points early in the front and that you’re hitting every piece that—every component
that the application is looking for. Karen Meyerson: Yes, and I would agree. And just do your research ahead of time,
and make sure that you have the statistics at your fingertips and any facts
that you might need as well. Chris Regal: Great. Let’s jump to another question. That’s great answers, very helpful,
I’m sure, to the listeners. Another plan asked, “If we are still working
on outcomes and the ROI data, can we apply for the award or should we wait until we have
the results before applying?” Tracey Mitchell: Hi. This is Tracey. I’ll go ahead and take that question. I think the stronger applications are able
to demonstrate health outcomes and returns—return on investment. We have had applicants who are kind of
in process who have applied and I can’t speak for them, but I think
it’s a good experience to apply even if your program is maybe not quite ready. And we’ve had applicants—what we do
after the competition and the panels review is we will give you feedback
on your application. And we have had applicants who have taken
that feedback to heart, have resubmitted, and have been winners the following year
or several years out. So I don’t want to discourage anyone
from applying. If you feel like you are at a good place
to apply, if you do have data to support your outcomes and are able
to demonstrate and address the criteria in the application,
I’d encourage you to apply. We recognize that it is labor-intensive,
it is—you know, it can be somewhat daunting. We have taken that feedback
from previous years. We’ve tried to consolidate, but again,
this is really the highest honor, the highest recognition in the country
for asthma programs, and so we feel like it needs to be a rigorous and competitive
application and a rigorous and competitive process in order to maintain the integrity. So having said that,
I hope I’m not discouraging you. I hope I’m encouraging you and
exciting you about being a potential winner. Chris Regal: Great. We had a question regarding outdoor and indoor
environmental triggers, or, “Do you focus mostly on
in-home asthma interventions? The plans featured today were about
some of the environmental triggers, and should—does the award focus mostly
on in-home asthma interventions?” Tracey? Tracey Mitchell: That’s a great question. We know that people spend 90 percent
of their time indoors, and I work in the Indoor Environments Division,
so that is a key part of the award. And we know that that’s a significant contribution
to asthma are indoor triggers, but there—in the criteria, it does ask
if you address outdoor air quality or outdoor—potentially out—outdoor triggers,
and one of our reviewers is from our Office of Atmospheric Programs,
the outdoor air folks. So, you know, we are always looking for
comprehensive programs, we’re looking for programs that address all triggers
as much as possible, and so I think if you are addressing both indoor and outdoor,
it’s a great thing to let us know. And if you’re specifically doing—conducting
either your organization or partnering with an organization who’s conducting in-home
assessments and in-home remediation, that’s really a key part of the criteria as well. Chris Regal: Great, great, great. And one question for the presenter. This one may be a little stray from the award but
“How do you think changes to the ACA will impact the sources of funding for in-home asthma care? Will health plans still be willing to reimburse
for asthma management services?” Karen Meyerson: This Karen Meyerson. I can only speak to the fact that Priority Health
has reimbursed for these types of services, as I said, for almost 18 years, so I don’t
anticipate that changing if the ACA does change. It was in place before the ACA
went into effect, and I’m sure it will continue to remain in effect. Chris Regal: Great. Karen Michael: And this is Karen Michael. I wouldn’t see any changes in our reimbursement
or projects around community health workers or any reimbursement for the community partners
changing based on the ACA. Karen Meyerson: Yes. Chris Regal: Great, great, great. Let me see. Questions keep coming in. If you do have any questions, please
send them over and we will try and answer them. I’m sorry. Go ahead. Karen Meyerson: Chris, this is Karen Meyerson. I just wanted to mention something too about
community health workers. There was a question that came through
about them. I can’t speak to reimbursement for CHWs,
but I am on the Asthma Educators Certification Board, and CHWs can become certified
as asthma educators. Typically, you would need to have a
credentialed health professional who would sit for the exam, but a CHW or an MA quits it
for the exam if they can demonstrate 1,000 hours of patient-level asthma education experience,
so that is something else for programs to consider, because health plans are asking for
that, for their—the individuals who are providing these services to have
the highest credential that is possible. And that—in this instance, that would be
a certified asthma educator, so CHWs can become certified as well. Chris Regal: Great, great. And similar question, “Do you know if there
are any partnering opportunities for indoor air quality inspectors
in the program?” Tracey, that one may be for you. Tracey Mitchell: That’s a good question. I think I would refer you to
our regional EPA offices. They may be able to connect you
with someone if you’re looking for— I don’t know if you’re looking for
a private company or if the question is addressing if EPA does inspections. But we do have 10—EPA does have
10 regional offices across the country. You could go to EPA.gov and search for
regional offices, and that would list which region you fall in by state, and you may be able
to contact them if you’re interested in, you know, finding out
about specific inspections. Chris Regal: Great, thank you. Again, I urge if anybody has
any last questions to please send them in. I have one more that was submitted
earlier in the presentation. “There were participants who indicated
that they are not currently working with a health plan but would like to. Is there a way to get a list of these organizations?” Tracey Mitchell: We typically don’t
publicize the list of participants. I think if someone has a specific request,
if you’d like to e-mail us or even through asthmacommunitynetwork.org,
you could search for programs in your area, whether it’s a health plan
or other asthma programs. You could connect with us through
Asthma Community Network, and we could connect you with a mentor.
As we mentioned earlier, not just health plans are mentors but other programs,
other award winners have served as mentors. So I think there are ways where we can help
you make connection. It wouldn’t be through necessarily publishing
the participant list. Chris Regal: Great. Thank you for clearing that up. That appears to be the last question
in the queue. I’ll give it another minute in case anyone’s
come in just before the deadline, but again, I want to call your attention to
the application deadline. It’s February 1, 11:59 p.m. We hope this webinar was helpful and that
people have been encouraged to apply. As you can tell from our speakers today, there
are some great opportunities to help people and be recognized by the EPA for your work. And I want to thank
all of our presenters today. Karen Meyerson, Karen Michael, Tracey Mitchell,
thank you for your presentations. I think this is great and extremely helpful. Karen Meyerson: Thank you, Chris. Chris Regal: And it looks like we do not have
any more questions in the queue. So with that, I think we will wrap up
this webinar. This will be available again on ahip.org/asthma
following the presentation. It will take a short period to get up,
but it will be hosted there long-term, as well as the aforementioned video series
will appear on ahip.org/asthma. And I also encourage you to look at the
chat functionality of this webinar for some very helpful links and resources. Again, thank you very much, and we appreciate
your time, and good luck with your applications.


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