Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

Michael M. Siegel, MD, Corporate Vice President and Medical Director, Utilization Management and Quality Improvement, Molina Healthcare Inc., 1 Golden Shore, Long Beach, CA 90802-4202, 562-951-8339, Michael.Siegel@MolinaHealthcare.com, Pshyra Jones, MPH, CHES, Manager, Disease Management Programs, Molina Healthcare Inc., 1 Golden Shore, Long Beach, CA 90802-4202, Keiko Higuchi, MPH, Senior Manager, Outcomes & Analytics, Pfizer Health Solutions Inc., 2400 Broadway, Suite 500, Santa Monica, CA 90404, and Jennifer Craighead, Team Leader/Senior Manager, Account Services, Pfizer Health Solutions Inc., 2400 Broadway, Suite 500, Santa Monica, CA 90404.

In the U.S., asthma minority health disparities are widely recognized. African Americans are 3 times more likely to be hospitalized for asthma than their white counterparts (National Center for Health Statistics: National Hospital Discharge Survey, 2001). Contributing to this widening gap in care is poor self-management skills and non-adherence to prescribed treatment. Many factors have been attributed to this disparity including patient-provider misunderstanding due to language and cultural barriers. Practitioner patient relationships and their attitudes towards each other can significantly affect the level of understanding and health behavior.

Molina Health Care Inc., a national managed Medicaid provider located in seven states, developed a care management program, Breathe with Ease, to help manage their asthma population. Supported by Pfizer Health Solutions' care management tools and services, the program is a comprehensive nurse/health educator directed, telephone-based asthma program. To address the health disparity issue and improve asthma self-management practices and impact on health care utilization, the Breath with Ease asthma program was culturally adapted for their minority Medicaid beneficiaries. Project CARE (Culturally Appropriate Resources for Encounters) was developed to evaluate the impact of culturally appropriate asthma services using a cultural concordance approach. Patients were randomized to language-specific educational materials and care manager/patient cultural concordance intervention group or comparison group without care manager/patient cultural concordance.

To date, over 2,123 adult participants identified to be actively care managed have been enrolled into Project CARE. After 9 months, improvements in the intervention (concordant) group were noted in day and evening symptoms frequency compared to the control group. For example, the intervention group's day symptoms had an 83% reduction while the control group had a 32% reduction (p<0.05). In addition, the intervention group had more improvement in self-management practices (use of controller medicine, use and knowledge of spacers, use and knowledge of peak flow meters) compared to the control (disconcordant) group. Also, more intervention group members were compliant in their medication regimen than the control group with 21% more believing their medication helps their condition and 7% more not stopping their regimen when feeling better or worse. Final clinical, utilization and financial results will be presented.

Learning Objectives: