In an unprecedented collaboration among HMOs, seven plans in Atlanta are partnering with a group of local providers and agencies to develop a model program to treat asthmatic children.
While the effort, called "Zap Asthma," wasn't conceived to improve the HMOs' image, it will "eliminate one of the arrows in the quiver of critics," conceded George Atkins, a spokesman for the American Association of Health Plans, a national managed-care trade group that initiated the project.
Inner-city Atlanta was chosen as the site for the project because it reports five times the national average of pediatric asthma cases, the AAHP said. Half the children in that area, which the U.S. Department of Housing and Urban Development has designated a federal empowerment zone, live in poverty.
Providers that have traditionally served the poor say they have been bypassed during HMOs' tremendous growth. Despite the dwindling resources allotted for indigent care, HMOs haven't addressed the problem.
Although "virtually all HMOs" are involved in community projects, this is the first time competing plans are collaborating in such a program, the AAHP spokesman said.
The AAHP is committed to raising the money to fund the effort, which it projects will cost $5 million over three years.
Using what it learns from the Atlanta project, the AAHP and its 1,000 member plans will begin to develop community-based healthcare programs across the country, the organization said in a written statement.
The HMOs in the partnership are Aetna Health Plans, Blue Cross and Blue Shield of Georgia, Cigna HealthCare of Georgia, Kaiser Foundation Health Plan of Georgia, Principal Health Care of Georgia, Prudential Health Care Plan and United HealthCare of Georgia.
Also involved in the project are the Atlanta Lung Association, the national Centers for Disease Control and Prevention, Clark/Atlanta University, Fulton County (Ga.) Health Department, the Georgia HMO Association, Grady Memorial Health Systems, Rollins School of Public Health of Emory University and HUD's Atlanta empowerment zone.
Over the next three years, Zap Asthma will recruit and train 15 community health workers to work with 200 families of children with asthma in Atlanta.
The program aims to improve the conditions that trigger asthma attacks, including cigarette smoke, inadequate ventilation, roach infestation, dirty carpets and dust-control problems. The goal is reduce emergency room visits, hospitalizations, and lost school and work days. The project will measure the number of such occurrences to track outcomes.
Each partner will take the lead in one aspect of the project. For example, HMOs will spearhead providing education about the causes of asthma and proper medications and will train community workers in case management. Grady Memorial will take the lead in clinical education, Atkins said.