Advancing California's community health worker & promotor workforce in Medi-Cal

Advancing California's community health worker & promotor workforce in Medi-Cal

Collection:
Health Policy and Services Research
Author(s):
Kelly, Logan, author
Benyo, Anna, author
Buck, Liz, author
Moses, Kathy, author
Nuamah, Audrey, author
Opthof, Emma, author
Contributor(s):
California HealthCare Foundation, issuing body.
Publication:
[Oakland, CA] : California Health Care Foundation, October 2021
Language(s):
English
Format:
Text
Subject(s):
Community Health Workers
Health Promotion
Health Workforce
Medicaid
Patient Navigation
California
United States
Genre(s):
Technical Report
Abstract:
In California and across the country, deep disparities in health outcomes based on race, income, and immigration status exist, which the COVID-19 pandemic has exacerbated. Reducing these disparities and improving health and well-being requires a person centered focus that integrates physical and behavioral health care with services that address health-related social needs. Community health workers and promotores (CHW/Ps) have a long history of providing culturally congruent, person-centered services that bridge these different systems and improving the health and well-being of the people they serve. CHW/Ps perform a variety of formal roles, from supporting care transitions and referrals to encouraging and educating patients on how to take care of their own health. What makes this workforce uniquely effective is their ability to establish trusting relationships with the people they serve, grounded in shared life experience and community connections. By forging trusted relationships, CHW/Ps not only engage with individuals in health-related activities but also help to change perceptions and encourage behaviors that contribute to better health outcomes. There is strong evidence that CHW/Ps can improve health outcomes and quality of care and reduce health care costs. Across health care settings and conditions, CHW/Ps advance health equity in diverse communities because they understand the root causes of challenges that people face and can help to develop tailored approaches that are more likely to be effective. CHW/P programs show a return on investment ranging from $2.28 to $4.80 for every dollar spent on CHW/Ps for managed care plans (MCPs). In California, there are new opportunities for MCPs to support the growth of this workforce so their members can benefit from CHW/P services. The California Advancing and Innovating Medi-Cal (CalAIM) initiative creates new imperatives for MCPs to meet member needs by supporting nonclinical interventions to address health-related social needs and to reduce health inequities, including through partnerships with community-based organizations and providers. MCPs can invest in CHW/P services to help achieve these goals. Two proposals in the CalAIM initiative--enhanced care management (ECM) and in lieu of services (ILOS)--offer MCPs financial mechanisms to contract with organizations that employ CHW/Ps and innovate how care is delivered. In responding to the requirements and opportunities of these CalAIM proposals, MCPs can apply lessons from California's Health Homes Program and Whole Person Care pilots; in many of these programs, MCPs either directly employed CHW/Ps or contracted with community partners that employ CHW/Ps. In addition to the opportunities presented by CalAIM, California is pursuing approval from the Centers for Medicare & Medicaid Services (CMS) to use federal Medicaid funds to support CHW/Ps in providing services as a benefit for Medi-Cal members, effective January 1, 2022. Through this funding, MCPs would have another opportunity to include CHW/Ps in member care.
Copyright:
Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
Extent:
1 online resource (1 PDF file (108 pages))
Illustrations:
Illustrations
NLM Unique ID:
9918333276706676 (See catalog record)
Permanent Link:
http://resource.nlm.nih.gov/9918333276706676