Connecticut, Michigan, and New York have successfully used Medicaid administrative data to conduct surveillance of asthma prevalence, related health service utilization and costs, and quality of asthma care. Since these assessments utilize beneficiary-level data, a wide range of population-based summaries is feasible. Opportunities exist to build upon the collective experiences of these three states to establish a national framework for asthma surveillance using Medicaid administrative data. This framework could be designed to respond to each state's unique data considerations and asthma management priorities, while establishing standardized criteria to enhance the comparability of asthma surveillance data among states. Importantly, a common asthma case definition using comparable methods is necessary to enable comparisons of prevalence estimates between states. Case definitions that could serve as the foundation for such a framework are presented. Mechanisms to foster sharing of methodologies and experiences will be instrumental for broad implementation across states. This collaboration will be of increasing importance as states experience mounting financial pressures due to increasing Medicaid enrollment and dwindling resources.
The experiences of Connecticut, Michigan, and New York illustrate that it is both feasible and valuable to use Medicaid administrative claims data to establish state-level systems for monitoring asthma prevalence, health service utilization, and quality asthma care.
Kevin J. Dombkowski, MS, DrPH, is Research Assistant Professor and faculty member, Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, University of Michigan, Ann Arbor.
Elizabeth A. Wasilevich, PhD, MPH, is Asthma Epidemiologist, Michigan Department of Community Health, Lansing, and Research Associate, CHEAR Unit, Division of General Pediatrics, University of Michigan, Ann Arbor.
Sarah Lyon-Callo, MS, is Chronic Disease Section Manager, Michigan Department of Community Health, Lansing.
Trang Q. Nguyen, MD, DrPH, is Senior Research Scientist, New York State Department of Health, Albany.
Michael G. Medvesky, MPH, is Team Leader of the Asthma Surveillance and Program Evaluation Team, New York State Department of Health, Albany.
Mary Alice Lee, PhD, is Senior Policy Fellow, Connecticut Voices for Children, New Haven.
Corresponding Author: Kevin J. Dombkowski, MS, DrPH, Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, University of Michigan, Ann Arbor, MI 48109 (firstname.lastname@example.org).
The authors thank the following individuals for their support and contributions to the Medicaid asthma surveillance process: Patrick J. Roohan, Victoria L. Wagner, and Patrick W. Sturn, Office of Health Insurance Programs, New York State Department of Health; Aaron Mair and Melissa Lurie, Public Health Information Group, New York State Department of Health; and Susan Moran, Michigan Medicaid program; and Amanda Learned, MAXIMUS, Inc., for data management and analysis of HUSKY Program data in Connecticut, under a contract with Connecticut Voices for Children for performance monitoring under the contract between the Connecticut Department of Social Services and the Hartford Foundation for Public Giving.