Federal and state health care reform measures bring many opportunities for greater integration of CHW services in order to address health disparities, increase the Triple Aim, and foster healthier communities.
The 2011 Patient Protection and Affordable Care Act (ACA) defines CHWs as members of the health care workforce and identifies CHWs as health professionals. The law specifies that funds granted under sec. 399V, subsection (a) shall be used to support CHWs to provide outreach, promote positive health behaviors, support enrollment in health insurance, identify, and enroll underserved populations to appropriate health care agencies and community based programs, and provide home visiting services related to maternal health and prenatal care. CDC funding for the use of CHWs in underserved communities was also included. In addition, the act expands the mandate of area health education centers (AHECs) to encompass the CHW workforce.
Federal guidelines open the door for CHWs to serve as navigators in state health insurance exchanges where they will help link low income, uninsured individuals and families with coverage options. Lessons from the Massachusetts health care reform experience point to the key role of CHWs in the successful enrollment of thousands of uninsured residents.
Minnesota’s Roadmap to a Healthier Minnesota and Healthy Minnesota 2020 both include CHW strategies as integral approaches for meeting key health improvement goals. Community health workers offer unique skill sets that can improve patients’ access to care and their health care outcomes. Recognizing and integrating these workers in the full scope of care, including appropriate reimbursement, will be a step toward improved care for many Americans.