Affordable Care Act

Realizing the Value of CHWs — New Opportunities for Sustainable Financing

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…

Integrating CHWs within Patient Protection and Affordable Care Act Implementation

J Public Health Manag Pract. 2015 Jan-Feb;21(1):42-50. [Pubmed Abstract]

Integrating community health workers within Patient Protection and Affordable Care Act implementation
Islam N, Nadkarni SK, Zahn D, Skillman M, Kwon SC, Trinh-Shevrin C

Context
The Patient Protection and Affordable Care Act’s (PPACA) emphasis on community-based initiatives affords a unique opportunity to disseminate and scale up evidence-based community health worker (CHW) models that integrate CHWs within health care delivery teams and programs. Community health workers have unique access and local knowledge that can inform program development and evaluation, improve service delivery and care coordination, and expand health care access. As a member of the PPACA-defined health care workforce, CHWs have the potential to positively impact numerous programs and reduce costs.

Objective
This article discusses different strategies for integrating CHW models within PPACA implementation through facilitated…

CHWs in Primary Care: Redesigning Health Care Systems to Improve Diabetes Care

Health Promot Pract. 2014 Nov;15(2 Suppl):51S-61S. [Pubmed Abstract]

Community health workers in primary care practice: redesigning health care delivery systems to extend and improve diabetes care in underserved populations
Collinsworth A, Vulimiri M, Snead C, Walton J

Abstract
New, comprehensive, approaches for chronic disease management are needed to ensure that patients, particularly those more likely to experience health disparities, have access to the clinical care, self-management resources, and support necessary for the prevention and control of diabetes. Community health workers (CHWs) have worked in community settings to reduce health care disparities and are currently being deployed in some clinical settings as a means of improving access to and quality of care. Guided by the chronic care model, Baylor Health Care System embedded CHWs within clinical teams in community clinics with the goal of reducing observed disparities in diabetes care and outcomes. This study…