OBJECTIVES: To determine whether primary care-based dispensing of asthma supplies and hands-on education to Medicaid subjects with asthma reduces asthma-related acute hospitalization and expenditures. METHODS: Keystone First (a Medicaid managed care organization) and a pharmacy services supplier deliver secured cabinets stocked with asthma medication and devices to participating providers and support reimbursable provider-led education, allowing dispensation and training in the use of asthma supplies at the member’s point of service. Home delivery of asthma supplies was arranged by pre-refill calls made to the member 4–5 days prior to the refill due date. Provider and medication rates (utilization per member per year and expenditures per member per month) were calculated from subject claims pre- and post-engagement. RESULTS: In 2014, 23 participating practices used secured asthma cabinets to dispense 12,822 asthma medications and supplies to more than 6,000 members. Subjects were primarily African American males living in Philadelphia, both children and adolescents (50% and 85% were ≤6 and ≤12 years old, respectively). About 400–500 pre-refill calls are made weekly to members to arrange home delivery of medications. A one-year pre/post analysis of all participating members in 2014 (N=2,962) demonstrated: 1) decreases in inpatient admissions and outpatient visits (−19.5% and −4.3%; p≤0.01) and corresponding expenditures (−35.2% and −5.5%; p≤0.01); 2) decreases in potentially preventable emergency department visits and expenditures (−23.8% and −26.7%); 3) no significant change in potentially preventable readmissions and expenditures (+4.2% and +4.7%; p>0.9); 4) increases in prescription utilization and expenditures (+20% and 59.4%); 5) slight increases in medication adherence (PDC, 0.04; MPR, 0.11; SD 0.42 and 0.37, respectively); and 6) significant expenditure savings (−20.2% and −10% with and without prescription, respectively; p<0.05). CONCLUSIONS: Point-of-service dispensing of asthma supplies for Medicaid subjects with asthma significantly increases outpatient and prescription-related utilization and expenditures, but significantly reduces asthma-related acute hospitalization and expenditures.