Provider organizations are under pressure to improve access and care quality at lower cost for a growing population of complex patients. Many providers struggle to meet these new imperatives, facing costly but avoidable acute utilization among Medicaid patients. That’s in part because unaddressed social needs compound clinical acuity for many patients. Traditional members of the care team aren’t equipped to effectively address these needs. However, evidence suggests that community health workers, non-clinical non-licensed workers sourced from the community, are.
Community health worker programs help to surface and address patients’ social needs as well as supporting chronic condition self-management in a financially sustainable way. Still, population health leaders struggle to make the case for investment because community health worker tasks aren’t clinical in nature and often not reimbursable.