How Hospitals Save with Community Heath Workers

Several pilot programs have shown reductions in long-term Medicare and Medicaid spending when employing CHWs in efforts to eliminate health care equalities. For more effectiveness in the future, many social and behavior determinants will need to be addressed. CHWs can also participate in health care costs.Findings indicate CHWs can have a positive impact on health outcomes. CHWs can:
  • Assist in identifying services
  • Identify medical homes for patients
  • Improve patient adherence to treatment
  • Improve the patient and provider care relationship
  • Provide screening and prevention services
  • Work closely with the health care team
  • Identify at-risk behaviors
  • Provide case management aide skills
  • Provide informal counseling
  • Identify linguistic and cultural gaps in communication
  • Provide care coordination
  • Reduce health disparities
  • Provide outreach methods and strategies
  • Provide appropriate cultural communication
  • Provide follow-up / advocacy in communities
  • Provide community capacity building
  • Provide health education #101 – Basic Health Education
  • Create positive patients
  • Extend patient care beyond the clinical visit by making home visits.
  • Provide appropriate cultural communication
  • Provide follow-up / advocacy in communities
  • Provide community capacity building
  • Provide health education #101 – Basic Health Education
  • Create positive patients
  • Extend patient care beyond the clinical visit by making home visits.

Financial Incentives

Hospitals that use Community Health Workers are able to reduce costs and improve patient outcomes. Below are examples of how major hospitals throughout the country are using Community Health Workers to improve the care they provide while improving their bottom line.

Click the name of each hospital to see the target population, CHW intervention, and outcome data.

Mount Sinai Hospital, Chicago
Target Population: AA children with uncontrolled asthma on Chicago’s Westside

CHW Intervention: Self-management education and support, home visits, trigger reduction, connect to primary care physician (PCP)

Outcome Data: $5.58 saved per dollar spent; Reductions in urgent health care utilization (75%)
Bronx Lebanon Hospital, NY; a patient-centered medical home
Target Population: Diverse NY patient population; English, French, Spanish and South Asian languages

CHW Intervention: Care management and supportive services (e.g. home visiting, system navigation)

Outcome Data: 2:1 ROI
Tri-County Rural Health Network Community Connector Program, Arkansas
Target Population: 3 Counties in the Mississippi Delta with a large low-income, minority rural population

CHW Intervention: Navigation from potential nursing home care to alternative home and community-based care

Outcome Data: $2.6 million savings to AR Medicaid over 3 years.
Community Health Worker Outreach Program, Baltimore, MD
Target Population: AA Medicaid patients with diabetes

CHW Intervention: Outreach, self-management support, system navigation to primary / specialty care, health insurance enrollment

Outcome Data: Cost-Savings of $80,000 to $90,000 per CHW per year; Reduction in ED visits (40%) , ER and hospital admissions (33%)
Lakewood Hospital, Cleveland Clinic Health System, Ohio
Target Population: Uninsured or low-income population

CHW Intervention: Discharge planning, connect to follow-up appointments with PCP at low-cost clinics or FQHC’s

Outcome Data: Saved over $150,000 in just six months; Reduced 30-day Medicare hospital readmissions and non-emergent self-pay ED visits
Denver Health, Colorado
Target Population: Underserved men

CHW Intervention: Outreach, connect with PCP, establish medical home, system navigation, case management

Outcome Data:2.28:1 ROI; increased primary and specialty care, decreased urgent care, inpatient and outpatient behavioral health utilization
The King County Asthma Program, Seattle, Washington
Target Population: Children with Uncontrolled Asthma covered by Medicaid

CHW Intervention: Self-management education, home visits, service coordination

Outcome Data: 1.9 ROI; Significant improvement in symptom-free days, caregiver quality of life and urgent health care utilization
The Langdale Company, Valdosta, GA
Target Population: Employees

CHW Intervention: System navigation, wellness coaching

Outcome Data: $4.80 per dollar spent; Reduced blood pressure, smoking and cholesterol levels, increased exercise and weight loss
Source: Illinois CHW Advisory Board Report, January 5, 2016

Hundreds of titles exist for Community Health Workers. Some of the common ones are listed below. Specialty areas have more specific titles.

 

Case Manager

Coach

Community Advocate

Community Care Coordinator

Community Engagement Specialist

Community Health Advisor

Community Health Advocate

Community Health Aide

Community Health Educator

Community Health Promoter

Community Health Representative

Community Health Worker

Community Organizer

Community Worker

Companero en Salud

Family Health Advocate

Health Worker

Helper / Supporter

Home Visitor / Support Worker

Lay Health Advisor

Lay Health Educator

Outreach Specialist

Outreach Worker

Parent Educator

Parent Support Partner

Patient Advocate

Patient Educator

Patient Navigator

Peer Counselor

Peer Health Advisory

Peer Leader

Peer Support Specialist

Peer / Teen Educator

Promotor(a) de Salud

Public Health Aide

Researcher