Getting Medicaid to Pay for Pest Control

For children who have asthma, pests like cockroaches and mice can trigger allergic reactions and lead to recurring and expensive hospital visits. Could insurers save money by investing in housing-based improvements like pest management services?

June 8, 2022, 7:00 AM PDT

By LM_Ortiz


Close-up of person spraying pest control

hedgehog94 / Pest control

There’s a connection between one’s home environment and asthma. An array of home-related factors can trigger or worsen asthma: pests such as cockroaches and mice can cause allergic reactions, and secondhand smoke, air pollution, and mold can make it worse. In New York City, children with asthma who are exposed to pests are three times more likely to be hospitalized, and they account for more than two-thirds of asthma-related rehospitalizations annually, according to the city’s Department of Health and Mental Hygiene (DOHMH).

The department recently launched a pilot project to zero in on pest-related pediatric asthma by delivering comprehensive pest management to patients’ homes—and tapping a group of Medicaid health insurers to fund it, even though such nonmedical interventions aren’t typically covered. If the three-year Medicaid Together Improving Asthma Program pilot succeeds in reducing repeat hospitalizations, the insurers should reap returns in the form of direct health care cost savings—but if not, a $1.2 million fund is in place to mitigate any losses.

“The environment in which a person lives directly affects their health,” says DOHMH project manager Beatrice Mauger, launch lead for Medicaid Together. “Our hope is to have a win-win for the health care sector and their clients. That can be achieved if this model shows the health care sector that investing in housing-based improvements can generate sustainable financial benefits.”

Over the years, other programs have worked more generally to tackle home health hazards that could exacerbate asthma, such as the U.S. Department of Housing and Urban Development’s Healthy Homes Program and the National Institute of Food and Agriculture’s Healthy Homes Partnership. At Boston Medical Center...

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