UMass Medical School policy brief describes why Connecticut should cultivate a workforce of community health workers

September 02, 2015

Community health workers (CHW) can improve health outcomes, reduce health disparities and contain costs, according to a brief authored by health policy experts at UMass Medical School and released by the Connecticut Health Foundation (CT Health).

The policy brief, Tomorrow’s Health Care System Needs Community Health Workers:  A Policy Agenda for Connecticut, lays out steps Connecticut can take to cultivate and integrate a robust community health worker workforce in the state’s health care system. It was written by Katharine London, MS; Margaret Carey, MPH; and Kate Russell, MA; of the Center for Health Law and Economics, a unit within UMass Medical School’s Commonwealth Medicine division. CT Health commissioned the analysis.

“CT Health hopes that this research provides the evidence and blueprint needed to convince key decision makers in Connecticut that community health workers must be supported through certification, training and legislation if the state is to meet the changing needs of the health care system,” said Elizabeth Krause, vice president of policy and communications.  

“CHWs’ interventions help patients to understand and to adhere to physicians’ instructions following a doctor visit. This is important as our health delivery model moves away from the traditional fee-for-service payment system to new value-based purchasing: paying for services in a way that rewards health care providers for delivering better care at lower cost,” Krause said.

CHWs are trusted members of communities they serve as they typically share ethnicity, culture, language, socioeconomic status, and life experiences with community members, according to the brief. Although CHWs do not deliver medical care, their cultural and linguistic understanding of their communities enables them to connect patients with health and community services, and to help patients take control of their health.

“Physicians often feel frustrated that they can’t influence their patients’ actions once they leave the office. CHWs extend health care beyond the clinic walls. They help their clients manage their own health,” said Katharine London, a principal in the Center for Health Law and Economics and lead author of the brief.

The policy brief cites research showing that CHWs can improve health outcomes and contain costs. It argues that CHWs can help clinical practices meet new quality standards – such as providing recommended preventive screenings and reducing the need for expensive emergency department visits  – and earn higher payments from health plans. Furthermore, new federal rules make it easier for state Medicaid programs to pay for CHW services.

The authors suggest that Connecticut can take these key steps to cultivate a robust CHW workforce:

  • Enact legislation establishing a process for certifying CHWs, along with training and experience requirements, to document CHWs’ skills for potential employers and insurers.
  • Implement the state’s SIM plan to establish training programs for CHWs and CHW supervisors to improve and standardize knowledge and skills.
  • Add CHW services to the set of Medicaid-covered services and establish a Medicaid payment rate to provide sustainable funding for these cost-effective services.
  • Provide training programs for health care providers on how they can use CHWs to help achieve practice transformation goals.
  • Establish a CHW task force to promote and coordinate this agenda.

CT Health is the state’s largest independent health philanthropy dedicated to improving lives by changing health systems. Since it was established in July 1999, the foundation has supported innovative grant-making, public health policy research, technical assistance and convening to achieve its mission – to improve the health of the people of Connecticut. Over the past 15 years, CT Health has awarded grants totaling $54 million in 45 cities and towns throughout the state.