Achieving the Triple Aim through Community Health Workers: Reimbursement Models that Align with the Affordable Care Act
Objectives: To collect feedback from CHWs and healthcare representatives concerning feasible reimbursement models and to identify reimbursement methods for different roles CHWs can have within ACA recommended reforms.
Methods: Models of effective CHW programs will be collected from other states based on literature and expert referrals. The perspectives of Connecticut CHWs will be integrated throughout the process of developing and conducting qualitative interviews with private and public payers.
Results: Reimbursement models that are aligned with the ACA will be identified and adapted for CHW roles within healthcare organizations. The models will focus on the integration of CHWs into the healthcare reform paradigm through public and private payers.
Conclusions: Collaboration with healthcare stakeholders and CHWs will take place to determine reimbursement models that can be adopted by healthcare organizations. The recommendation of reimbursement models will be based on feedback from public and private payers who are involved in payment, health promotion, and delivery reforms. Future action steps for sustaining these models will be discussed in order to achieve the Triple Aim of the ACA.
Learning Areas:Conduct evaluation related to programs, research, and other areas of practice
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Public health or related research
Describe how CHWs help accomplish the goals of ACA. Assess the reimbursement methods of other states in regard to ACA guidelines. Analyze feedback and recommendations from CHWs and healthcare representatives regarding reimbursement. Identify different reimbursement models for the various roles of CHWs in healthcare organizations. Discuss future action steps for reimbursement models that are in alignment with the payment, health promotion, and delivery reforms.
Keyword(s): Community Health Workers and Promoters, Affordable Care Act
Qualified on the content I am responsible for because: As a healthcare consultant, projects involve the implementation of PPACA reforms.I have presented at CHW conference/panel discussion,worked on final reports with SWAHEC about payment methods for CHWs.I am a member of the NE CHW Coalition and NE Health Equity Council.I also work as a Research Assistant on women's,children's,and malpractice health policies.This background enables me to combine my knowledge of implementing PPACA programs and health policy while researching which reimbursement models could be sustainable for CHWs.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.