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EmblemHealth Asthma Project

Cross-Cultural Training of Health Care Providers  

EmblemHealth is committed to overcoming barriers to care, addressing health disparities in the community and training employees to recognize the specific needs of the communities it serves. The plan offers a robust culturally competent training curriculum focusing on equipping clinical staff with the skills to mitigate three barriers impeding minorities from getting equal care — the stereotyping of cultures by clinicians, minorities' mistrust of clinicians and, most important, lack of effective communication. By role-playing in mini-case vignettes, participants learn strategies for cross-cultural communication, including taking the time to speak slowly, using titles to show respect, and smoothing out culturally insensitive behavior that can occur during a phone call. This training will be extended to non-clinical staff in 2012. 

Additionally, EmblemHealth sponsored The Medical Manual for Religio-Cultural Competency, written by the Tanenbaum Center for Interreligious Understanding. The Medical Manual is designed to help doctors and other health care professionals improve quality of care by addressing the needs of patients whose health care decisions are influenced by their religious and cultural beliefs. This publication is available to all EmblemHealth network practitioners on the plan’s web site to help improve and enhance communication between clinicians and their patients.

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Identification and Enrollment
Outreach and Education
Results 

Identification and Enrollment 

Serving New York residents, and situated in a high asthma utilization area, EmblemHealth developed an asthma care management program to increase compliance among members, 5-50 years of age, in their use of controller medications for the treatment of persistent asthma.  Members with asthma are entered into the asthma program in one of four ways:

• Emergency department visit for asthma
• In patient discharge with diagnosis of asthma
• Four prescription fills for asthma medications
• Four outpatient visits with asthma as a diagnosis and two asthma medication prescription fills

Members with the diagnosis COPD, cystic fibrosis, emphysema or acute respiratory failure are excluded from the project:

Outreach and Education 

EmblemHealth’s asthma project includes outreach and education to both members with asthma and providers that care for these patients.  The plan’s extensive disease management program offers educational material and tools to members diagnosed with asthma.  This information is distributed via newsletter articles discussing ways to prevent and treat asthma to members as well as their provider network.  Targeted approaches include individualized letters to members with asthma to highlight the importance of using a controller medication.  Members who have been recently discharged from a hospital with an asthma diagnosis are also provided information about the importance of an action plan.   

EmblemHealth also works with their provider networks by identifying members and informing physicians of patients who have filled a prescription for a reliever but not a controller.  Providers are also informed of patients who were recently discharged with an asthma diagnosis so that follow-up appointment can be established.   

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Results 

Between 2009 and 2010, EmblemHealth has seen slight increases in percentage of members filling at least one prescription for a controller medication across all plan products, as well as a close to 5% to 9% increase among Commercial and Medicaid members filling three or more prescriptions for controller medications. 

Table 1: Percentage of Members Filling at least 1 prescription for a Controller Medication 

Table 2: Percentage of Members Filling 3 or More Prescriptions for Controller Medications 

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