N Engl J Med. 2019 May 23;380(21):1990-1992. [Pubmed Abstract]
Lapidos A, Lapedis J, Heisler M
Health care financing in the US, especially since the passage of the Affordable Care Act (ACA) or “Obamacare,” has increased opportunities for financing peer support and community health worker (CHW) programs. In this week’s Tuesday Tip, our colleague, Michele Heisler, and two of her other colleagues from the University of Michigan, Adrienne Lapidos and Jeremy Lapedis outline the case for routine financing of CHWs and several possible mechanisms and paths to accomplish this.
Opportunities include 2018 Medicare provisions to cover CHW and other nonmedical benefits especially for those with chronic diseases. This follows earlier Medicaid provisions included in the ACA to cover CHW and other supportive services for those with mental health and chronic conditions. Medicaid has also updated rules to encourage Medicaid MCOs to cover services including those addressing social…
Am J Public Health. 2017 Oct;107(10):1660-1667. [Pubmed Abstract]
Kangovi S, Mitra N, Grande D, Huo H, Smith RA, Long JA
To determine whether a community health worker (CHW) intervention improved outcomes in a low-income population with multiple chronic conditions.
We conducted a single-blind, randomized clinical trial in Philadelphia, Pennsylvania (2013-2014). Participants (n = 302) were high-poverty neighborhood residents, uninsured or publicly insured, and diagnosed with 2 or more chronic diseases (diabetes, obesity, tobacco dependence, hypertension). All patients set a disease-management goal. Patients randomly assigned to CHWs also received 6 months of support tailored to their goals and preferences.
Support from CHWs (vs goal-setting alone) led to improvements in several chronic diseases (changes in glycosylated hemoglobin: -0.4 vs 0.0; body mass index: -0.3 vs -0.1; cigarettes per day: -5.5 vs -1.3; systolic blood pressure: -1.8 vs…
Jack HE, Arabadjis SD, Sun L, Sullivan EE, Phillips RS
J Gen Intern Med. 2016 Dec 5. [Pubmed Abstract]
As the US transitions to value-based healthcare, physicians and payers are incentivized to change healthcare delivery to improve quality of care while controlling costs. By assisting with the management of common chronic conditions, community health workers (CHWs) may improve healthcare quality, but physicians and payers who are making choices about care delivery also need to understand their effects on healthcare spending.
We searched PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PsycINFO, Embase, and Web of Science from the inception of each database to 22 June 2015. We included US-based studies that evaluated a CHW intervention for patients with at least one chronic health condition and reported cost or healthcare utilization outcomes. We evaluated studies using tools specific to study…