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Area 3: Sustaining the Program

Award Criteria » Application Guidelines and Evaluation Criteria for Health Plans » Area 3: Sustaining the Program

Describe the environmental management services that are covered or, if coverage is not yet available, describe the effort that is under way to help establish coverage to sustain your asthma program's environmental components.

Area 3. Sustaining the Program (15 points)

Application Guidelines Evaluation Criteria
  • Describe the environmental components for asthma care that are covered under your plan types or the strategies that are in place to help achieve coverage for environmental components in the near future.
  • If applicable, describe payment and delivery models (e.g. shared savings, PCMHs, ACOs, etc.) currently in place to improve the quality of care for patients with asthma. 
  • Long-term strategies for sustaining the environmental management components of the asthma program are in place. comprehensive asthma program are in place.
  • Program communicates cost savings data, both internally and externally.
  • Program contains an effective payment and delivery model for environmental asthma services, or a commitment to making plans for coverage of these services a reality through concerted efforts and practices.
    • Example: "LA Cares About Asthma® is funded as part of L.A. Care Health Plan's budget. Funding provided to CBOs for in-home asthma visitation programs are reimbursed at an established case rate, inclusive of all visits, follow up phone calls, and environmental management supplies and tools provided to members. The Harbor-UCLA MFI contract is reimbursed at the Medi-Cal (Medicaid) fee-of-service rate for services provided to high-risk asthma members."
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