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…