Community Health Workers (CHWs) Make Cents: A Return on Investment Analysis

BACKGROUND: Despite a growing presence of CHW programs in recent years as a cost effective, preventative health measure, full financial and health impacts are inadequately documented.  CHW roles continue to diversify, and now include outreach and referral-based CHWs, case managers, and health insurance marketplace navigators to name a few.  A small number of studies have formally evaluated the long-term economic return from this these types of programs.  One method is to perform a Return on Investment (ROI) analysis, which estimates the cost return for every dollar invested.

METHODS: Participating Federally Qualified Health Centers (FQHCs) of various sizes will share data on their CHW program finances and health outcomes.  Financial data shared will include CHW wages, training, supervision, evaluation, materials, transportation, and other relevant expenses.  Outcome data will include numbers of referrals, appoints kept, new diagnoses and patients linked to treatment, clinical measures (i.e. BMI, BP, HbA1c, etc.), and individuals successfully enrolled in to health insurance, varying by program.  Healthcare savings associated with these outcomes will be estimated using current literature.

RESULTS: We will present ROI results for participating clinics and share best practice recommendations for application in similar programs around the country. 

CONCLUSIONS: An ROI analysis will be used to evaluate existing programs, determine sustainability of continued program investment, and help to compare the efficacy of different CHW models.