The federal government as well as many states are taking greater interest in the CHW role. At the federal level, exciting policy developments include the Dept of Health and Human Services Working Group on CHWs, HUD’s CHW Initiative, CMS Medicare Diabetes Disparities pilots and the CMS Center for Innovation’s Workforce Innovation Awards.
The Patient Protection and Affordable Care Act lists CHWs as a member of the health care workforce and as a health professional. It defines CHW as “an individual who promotes health or nutrition within the community in which the individual resides.”
According to the law, a CHW promotes health in the following ways:
New CHW investigations are underway in Delaware, Missouri, North Dakota and Utah while Massachusetts pursues a year-long effort to establish a CHW certification process under the direction of a new board of certification and with input from CHWs from around the state.
New CHW developments in Arizona, Illinois, Missouri, New Mexico and South Carolina share some common characteristics including: focused education and awareness, agreement on scope and qualifications/skill standards, move towards certification on the part of many, strategy for sustainable financing, resources for workforce development and mobilizing CHWs to participate (Carl Rush, Oct 2012).
Spotlight: Oregon Coordinated Care Organizations
CHWs are integral to Oregon’s Coordinated Care Organizations (CCOs) with global payments to 15 regions to achieve quality metrics for Medicaid enrollees. Benefits and services are integrated and coordinated with a focus on prevention, primary care, and chronic disease management. CCOs address regional, cultural, socioeconomic and racial disparities in health. Find out more in this Washington Post article.
In the Central Oregon pilot, CHWs made a difference by addressing behavioral health issues and better meeting patient needs. They reduced emergency department visits by 49% leading to a decrease in net costs by more than $600,000 in the first six months. Get a full description here.