July 15, 2014
1 min read
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Annual Medicaid costs for pediatric asthma-related ED visits topped $270 million

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State Medicaid programs spent an estimated $272 million on pediatric asthma-related ED visits in 2010, according to recent CDC data.

William S. Pearson, PhD, MHA, health scientist, CDC, and colleagues estimated state-based costs for asthma-related ED visits among children aged younger than 18 years, where the primary payer was Medicaid/Children’s Health Insurance Program (CHIP).

William S. Pearson, PhD, MHA

William S. Pearson

 “Because data on pediatric asthma ED visits were not available for all states, we constructed a ‘second-best’ approximation by using multiple sources of data that may not have included data from the same years,” the researchers wrote.

For Medicaid/CHIP enrollees, there were approximately 629,000 pediatric asthma ED visits in 2010, costing $272 million for an average per-visit cost of $433. California, Georgia, Florida, New York, Illinois, Pennsylvania and Texas spent an estimated $10 million each on asthma-related visits in 2010. Statewide costs ranged from $282,000 in Alaska to more than $25 million in California.

“Costs to states for pediatric asthma ED visits vary widely,” the researchers concluded. “Effective Jan. 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).

“The CMS rule change … may help states reduce costs of asthma treatment and at the same time reduce the severity of this condition through better management. Reduced costs for treating asthma may improve the overall quality of life and productivity for children and adolescents by improving asthma symptoms and reducing the number of school days missed due to asthma.”

Disclosure: All research work was conducted by CDC employees.