The Rhode Island Asthma Control Program (RIACP) is part of the Center for Chronic Care and Disease Management (CCDM) in the Division of Community Health and Equity (CHE) at the Rhode Island Department of Health (RIDOH). RIACP was established in 1999 and for over 20 years has built an award-winning, nationally recognized state asthma program with robust infrastructure, strong cross-sector partnerships, and successful evidence-based comprehensive asthma services. Economic evaluations have demonstrated a positive Return on Investment (ROI) and RIACP is deeply embedded in statewide health system transformations to integrate comprehensive evidence-based asthma control interventions into the health care delivery system. RIACP proposes expansion of comprehensive asthma services through leveraging relationships with RI Medicaid, Managed Care Organizations (MCOs), Accountable Entities (AEs), Hospital systems, and the statewide multi-payer Care Transformation Collaborative/pediatric Patient Center Medical Home (CTC-RI/PCMH-Kids) quality improvement initiative.
RIACP’s Comprehensive Integrated Asthma Care System (CIACS) model links public health and healthcare in a framework to coordinate asthma interventions across systems including healthcare, housing, education, transportation, environmental health, and community. RIACP is proposing to utilize an enhanced CIACS model that integrates RIDOH’s leading priorities that have been adopted as statewide population health goals: 1) addressing the socioeconomic and environmental determinants of health; 2) eliminating the disparities of health and promoting equity; and 3) ensuring access to quality health services for Rhode Islanders including vulnerable populations. RIDOH’s leading priorities inform the place-based implementation of the EXHALE strategies. Implementation will be prioritized in areas with elevated asthma burden, based on RIACP surveillance data, and will be in alignment with development of a new RI Asthma Strategic Plan and Strategic Evaluation Plan. RIACP’s well-established cross-sector partnerships will be part of all implementation strategies and the development of the Strategic Plan and related evaluation activities.
The overall outcomes expected from RIACP’s proposal include the CCARE outcome of preventing asthma emergency department visits and hospitalizations in children, along with overall outcomes of improved asthma health, lower healthcare costs, and better asthma care. RIACP adopts the CDC logic model and expects to achieve all short-term, intermediate and long-term outcomes. By 2024, RIACP expects to achieve: improved health and quality of life with more people having well-controlled asthma; lower costs with reduced asthma ED visits and hospitalizations; and better care with widespread use of comprehensive asthma control services resulting in reduced asthma disparities.