Online Program

Community Health Workers Achieving Health Equity within Population Health in New England: Advanced Payment Models Aligned with the Affordable Care Act

Wednesday, November 4, 2015 : 8:50 a.m. - 9:10 a.m.

Rumana Rabbani, MHA 2017 Candidate, Dept. of Health Policy & Management, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC
Barbara Ginley, MPH, Maine Migrant Health Program, Augusta, ME
Dannie Ritchie, MD, MPH, Center for Primary Care and Prevention, Brown University, Providence, RI
Durrell J. Fox, BS, CWM-CHPR, New England AIDS Education and Training Center -UMASS Medical School, Shrewsbury, MA
Background: Community Health Workers (CHWs) are trusted, frontline public health personnel who improve population heath, care experience, and per-capita cost.   As well-informed members of their community, CHWs are highly effective public health workers who engage and educate marginalized individuals to realize health equity despite race or socioeconomic status.  CHWs are recognized under the Affordable Care Act (ACA); however, there are many challenges to integrating and optimizing CHW roles as public health workers.  Although, CHWs are mostly funded through grants, our previous research indicates that some payers are starting to adopt funding that conforms to ACA payment guidelines for CHW workforce sustainability and recognition as a profession.

Objectives: To collect feedback from New England public health and payer representatives regarding sustainable funding for CHWs, and to recommend payment models encouraged through the ACA.

Methods: Models of sustainable funding for New England CHW programs will be reviewed based on environmental scans.   Healthcare reform programs, ACA payment model guidelines, and CHW feedback will be used to develop qualitative interviews for public and private payers. Data will be coded to extract research findings.

Results:  Advanced payment models encouraged by the ACA for CHWs will be identified through literature review.  Findings of sustainable funding for CHWs will be evaluated. 

Conclusions:  Collaboration with policy officials and public health stakeholders will identify payment models that include reimbursement for CHWs within community outreach programs in New England.   Recommendations for sustainability will be based on secondary research and feedback from payers. Implementation of these models will be discussed to help achieve health equity.

Learning Areas:

Advocacy for health and health education
Implementation of health education strategies, interventions and programs
Other professions or practice related to public health
Public health or related education
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
Describe different CHW interventions in New England that show positive outcomes for the social determinants of health. Assess the sustainable funding for CHWs in New England states in regards to ACA guidelines. Compare feedback and recommendations from CHWs, public health stakeholders, and policy officials regarding sustainable funding. Evaluate findings from public and private payers about their perception of implementing advanced payment models within public health reform programs for the CHW workforce. Identify at least five different advanced payment models for the sustainability of CHWs in population health. Discuss future action steps for executing advanced payment models to achieve health equity.

Keyword(s): Community Health Workers and Promoters, Funding/Financing

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working on healthcare consulting projects involving the implementation of ACA reforms, and as a Research Assistant on Medicaid health policies. I have also been working with Community Health Workers (CHWs), healthcare/public health stakeholders, and policy officials from organizations such as Regional Health Equity Council,Southwestern Area Health Education Center,and CHW section of APHA to address the issues of health equity and CHW sustainability.I have conducted previous Community-Based-Preparatory Research about CHW sustainability and funding.
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.