Reducing Potentially Preventable Emergency Department Visits (PPVs) through a Telehealth Intervention in Children with Asthma within a Managed Care Organization (MCO)

Authors

• Renee A. Roker, University of Texas Health at HoustonFollow

Date of Doctor of Nursing Practice Project Completion

Summer 8-7-2026

Faculty Advisor

Debbie Cline, DNP, RN, CNL®, OCN®, NEA-BC

Abstract

Abstract

Purpose:  The purpose of this quality improvement project was to reduce unnecessary ED utilizations among children with asthma enrolled in a Medicaid managed care health plan. The project aimed to improve access to care and enhance asthma self-management.

Background:  Asthma is one of the leading causes of Emergency Department (ED) utilization, among vulnerable populations. Members experience barriers to timely primary and specialist care, contributing to Potentially Preventable ED Visits (PPV) rates. This places managed care organizations (MCOs) at risk for financial penalties if not meeting the Texas PPV benchmark.

Methodology:  Guided by the Chronic Care Model, Lean Six Sigma framework with PDSA cycles, a multidisciplinary telehealth intervention was implemented for 21 pediatric asthma members. ED utilization was measured using Pre- and Post- intervention ED claims data, and PPV rates assessed using 3M^TM Population-Focused Preventable software. Descriptive statistics were used to summarize the participants demographics to characterize the study population.

Results:  ED visits decreased by 75% (40 to 10), while PPVs decreased by 94.1% (34 to 2). Telehealth engagement increased from 14 to 96 visits following the multidisciplinary telehealth model, and 72.4% of participants obtained a personalized asthma action plan.

Implications:  The findings support multidisciplinary telehealth interventions as an effective and sustainable approach to improving asthma management and reducing PPVs among pediatric populations. This model may help MCOs improve quality performance, increase access to care, and guide future disease management programs.

Keywords

Asthma Management, Telehealth, Pediatric care, Reducing emergency room visits in children with asthma, Telehealth intervention for pediatric asthma management

Recommended Citation

Renee A. Roker, "Reducing Potentially Preventable Emergency Department Visits (PPVs) through a Telehealth Intervention in Children with Asthma within a Managed Care Organization (MCO)" (2026). Doctor of Nursing Practice Final Project Abstract. 217.
https://digitalcommons.library.tmc.edu/dnp_abstract/217