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Le Bonheur’s risk-based innovation program Changing High-Risk Asthma in Memphis through Partnership (CHAMP) significantly decreased health care use related to asthma by targeting barriers to asthma care, according to research published in the Annals of Allergy, Asthma & Immunology.

After one year of enrollment in the program, results analyzing 945 children included a 48% reduction in Emergency Department (ED) visits, 68% reduction in inpatient and observation visits, 42% reduction in urgent care visits and 53% reduction in asthma exacerbations. Asthma exacerbations per patient significantly decreased from 2.97 to 1.4.

“Children in Shelby County, which includes the Memphis metro area, have disproportionally high asthma-related health care resource use compared with other regions in Tennessee,” said Christie Michael, MD, Le Bonheur allergist/immunologist and medical director for the CHAMP program. “Our results show that taking down the walls of the clinic and going to where kids live, play and go to school has been a success.”

The study analyzed data for children who had completed one full year of the program between January 2013 and Dec. 31, 2022. Of 1,348 children enrolled, 945 completed a full year of the program. The demographics of the participants were 63% male and 90% Black with a mean age of 6.8 years old.

The CHAMP program was developed with a goal of improving asthma care and reducing risk of exacerbation for patients with high-risk asthma, who have significantly increased morbidity and mortality and, consequently, higher use and cost of health care. High-risk asthma can be defined in a few ways, including asthma that causes higher health care use, is poorly controlled despite appropriate medical management or is controlled but requires the maximum medications available. The areas around Le Bonheur have the highest rate of ED visits and hospitalizations for asthma in the state, which is twice as high for kids with Medicaid compared to those with private insurance.

Christie Michael, MD, medical director of the CHAMP program

The CHAMP program evolved over time, getting a jumpstart from a Centers for Medicare & Medicaid Services (CMS) grant in 2012. Patients with high-risk asthma are eligible for the program if they are residents of Shelby County, aged 2-18 years and enrolled in Medicaid or TennCare. For the program, high-risk asthma means the patient has had one of the following: three or more asthma-related ED or urgent care visits in the previous year; two or more asthma-related hospitalizations in the previous year; any admission to the intensive care unit (ICU).

Some of the unique aspects of the program include:

• 24/7 CHAMP call line for guidance on care at home or if escalation to urgent care or ED is needed
• Dedicated medical team and clinic to provide coordination of care and proper asthma education
• Home visits from community health educators
• Respiratory therapist who communicates a child’s asthma action plan with school nurses and primary care providers
• Asthma repository where providers can download claims data for TennCare patients to see all medical encounters and if prescriptions are filled

The CHAMP program represents an innovative way to care for children with chronic disease that not only improves their outcomes but also could lower the cost of health care for each child. After a third-party evaluation of the CHAMP program following the original three-year grant period with the CMS, health care costs were reduced by $545 per child per quarter with a total reduction of $2,180 per year.

CHAMP seeks to change the standard for caring for these kids by addressing key factors that lead to high health care use and exacerbation of asthma. A dedicated medical care team works to provide the best outcomes for these children by working outside of the traditional paradigms of health care.

Community Health Educator Tammy Lewis (above left) meets a patient in her home to provide education and support.