Community health workers and state level policies: An analysis of policies aimed at improving care and decreasing spending

Community Health Workers (CHWs) are skilled community members that work with the local healthcare system to improve health outcomes through a variety of strategies. They have been shown to reduce overall health care costs through improvements in community engagement and preventive care services. Among other findings, studies examining the work of CHWs have reported: >50% reductions in emergency room visits and hospitalization rates; >20% reductions in annual Medicaid spending; increases in Medicaid enrollment and improved access to care, knowledge, behaviors, and patient outcomes. In response to CHWs' ability to improve care and lower costs, the states and federal government have recently enacted an increasing number of policies aimed at furthering the engagement of CHWs.

Public health experts contend that comprehensive CHW policies are critical to expediting the integration of the CHWs into healthcare systems. However, there are no uniform standards for CHW scope of practice, training, accreditation, or reimbursement. A few states, such as Massachusetts and Minnesota, have enacted comprehensive CHW policies with the aforementioned provisions and may serve as a blueprint for other states seeking guidance in enacting their own CHW policies. This presentation will: (1) explore Massachusetts' recommendations for elements of a comprehensive CHW policy; (2) analyze the key provisions of existing state CHW policies; and 3) discuss the value of a national policy database containing CHW and other policies as a unique resource for states interested in adopting CHW policies as well as researchers evaluating the impact of state CHW policies.