The Journal of Pediatrics
Volume 152, Issue 4 , Pages 481-488 , April 2008

Health Plan Notification and Feedback to Providers is Associated with Increased Filling of Preventer Medications for Children with Asthma Enrolled in Medicaid

  • William O. Cooper, MD, MPH

      Affiliations

    • Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN
    • Corresponding Author InformationReprint requests: William O. Cooper, MD, MPH, Department of Pediatrics, Vanderbilt University Medical Center, AA-0216 MCN, Nashville, TN 37232-2504.
    • ,
  • Wayne A. Ray, PhD

      Affiliations

    • Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN
    • ,
  • Patrick G. Arbogast, PhD

      Affiliations

    • Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN
    • ,
  • Michelle Garrison, PhD

      Affiliations

    • Child Health Research Institute, University of Washington School of Medicine, Seattle, WA.
    • ,
  • Judith A. Dudley

      Affiliations

    • Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN
    • ,
  • Dimitri A. Christakis, MD, MPH

      Affiliations

    • Child Health Research Institute, University of Washington School of Medicine, Seattle, WA.

Received 22 February 2007 ,Revised 25 June 2007 ,Accepted 31 August 2007.

References 

  1. Cooper WO, Hickson GB, Mitchel EF, Ray WA. Comparison of perinatal outcomes among TennCare managed care organizations. Pediatrics. 1999;104(3 Pt 1):525–529
  2. Harris KM, Gordon-Larsen P, Chantala K, Udry JR. Longitudinal trends in race/ethnic disparities in leading health indicators from adolescence to young adulthood. Arch Pediatr Adolesc Med. 2006;160:74–81
  3. Shibuya K, Boerma JT. Measuring progress towards reducing health inequalities. Bull World Health Organ. 2005;83:162
  4. Mann C, Rowland D, Garfield R. Historical overview of children’s health care coverage. Future Child. 2003;13:31–53
  5. Coughlin TA, Zuckerman S. Three years of state fiscal struggles: how did Medicaid and SCHIP fare?. Health Aff. 2005;(Millwood); Suppl Web Exclusives:W5-385-98.
  6. Cunningham PJ. Medicaid cost containment and access to prescription drugs. Health Aff. 2005;24:780–789(Millwood)
  7. Cooper WO, Kuhlthau K. Evaluating medicaid managed care programs for children. Ambul Pediatr. 2001;1:112–116
  8. Center for Medicare and Medicaid Services. Medicaid managed care (Center for Medicare and Medicaid Services). Accessed Dec 13 http://www.cms.hhs.gov/MedicaidManagCare/2006;
  9. Epstein AM. Medicaid managed care and high quality (Can we have both?). JAMA. 1997;278:1617–1621
  10. Gold M, Sparer M, Chu K. Medicaid managed care: lessons from five states. Health Aff (Millwood). 1996;15:153–166
  11. Gold M, Aizer A. Growing an industry: how managed is TennCare’s managed care?. Health Aff. 2000;19:86–101(Millwood)
  12. Iglehart JK. Medicaid and managed care. N Engl J Med. 1995;332:1727–1731
  13. Cooper WO, Arbogast PG, Hickson GB, Daugherty JR, Ray WA. Gaps in enrollment from a Medicaid managed care program: effects on emergency department visits and hospitalizations for children with asthma. Med Care. 2005;43:718–725
  14. Washington State Department of Social and Health Services. Healthy Options enrollment (Washington State Department of Social and Health Services 2006). Accessed Dec 13 http://fortress.wa.gov/dshs/maa/HealthyOptions/2006;
  15. Ray WA, Griffin MR. Use of Medicaid data for pharmacoepidemiology. Am J Epidemiol. 1989;129:837–849
  16. Sox CM, Cooper WO, Koepsell TD, DiGiuseppe DL, Christakis DA. Provision of pneumococcal prophylaxis for publicly insured children with sickle cell disease. JAMA. 2003;290:1057–1061
  17. ICD-9-CM International classification of diseases, ninth revision, clinical modification. 6th ed. Washington, DC: US Department of Health and Human Services, Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services; 2002;
  18. Current procedural terminology. 4th ed. Chicago: American Medical Association; 1999;revised
  19. National Institutes of Health National Heart LaBI. Highlights of the expert panel report 2: guidelines for the diagnosis and management of asthma. NIH Publication No. 97-4051A. Bethesda, MD: NIH; 1997;
  20. Farber HJ, Chi FW, Capra A, Jensvold NG, Finkelstein JA, Lozano P, et al. Use of asthma medication dispensing patterns to predict risk of adverse health outcomes: a study of Medicaid-insured children in managed care programs. Ann Allergy Asthma Immunol. 2004;92:319–328
  21. Lieu TA, Quesenberry CP, Sorel ME, Mendoza GR, Leong AB. Computer-based models to identify high-risk children with asthma. Am J Respir Crit Care Med. 1998;157(4 Pt 1):1173–1180
  22. Dudley RA, Landon BE, Rubin HR, Keating NL, Medlin CA, Luft HS. Assessing the relationship between quality of care and the characteristics of health care organizations. Med Care Res Rev. 2000;57(Suppl 2):116–135
  23. Landon BE, Epstein AM. Quality management practices in Medicaid managed care: a national survey of Medicaid and commercial health plans participating in the Medicaid program. JAMA. 1999;282:1769–1775
  24. Adams RJ, Fuhlbrigge A, Finkelstein JA, Lozano P, Livingston JM, Weiss KB, et al. Use of inhaled anti-inflammatory medication in children with asthma in managed care settings. Arch Pediatr Adolesc Med. 2001;155:501–507
  25. DiGiuseppe DL, Christakis DA. Continuity of care for children in foster care. Pediatrics. 2003;111:e208–e213
  26. Lozano P, Grothaus LC, Finkelstein JA, Hecht J, Farber HJ, Lieu TA. Variability in asthma care and services for low-income populations among practice sites in managed Medicaid systems. Health Serv Res. 2003;38(6 Pt 1):1563–1578
  27. Kemp J. Is there a best outcome measurement for patients with asthma?. Ann Allergy Asthma Immunol. 2006;97:432–439
  28. Adams RJ, Fuhlbrigge A, Finkelstein JA, Lozano P, Livingston JM, Weiss KB, et al. Impact of inhaled antiinflammatory therapy on hospitalization and emergency department visits for children with asthma. Pediatrics. 2001;107:706–711
  29. Fuhlbrigge A, Carey VJ, Adams RJ, Finkelstein JA, Lozano P, Weiss ST, et al. Evaluation of asthma prescription measures and health system performance based on emergency department utilization. Med Care. 2004;42:465–471

 Conflicts of Interest: Drs Ray and Arbogast report receiving grant support from Pfizer for work unrelated to the research reported in this manuscript.

 Supported by the Agency for Healthcare Research and Quality (HS#13076) and the Agency for Healthcare Research and Quality, Centers for Education and Research on Therapeutics (HS#10384). The funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review, or approval of the manuscript. The first draft was written by Dr Cooper.

PII: S0022-3476(07)00847-5

doi: 10.1016/j.jpeds.2007.08.046

The Journal of Pediatrics
Volume 152, Issue 4 , Pages 481-488 , April 2008

Article Tools

* Image Usage & Resolution