Impact of Community Health Workers (CHW) in the Primary Health Care Setting

Since the 1960s, Community Health Workers (CHWs) have been characterized as community leaders who share the language, socioeconomic status and life experiences of the community members they serve and are recognized as a promising strategy to address glaring health inequities. Testimony the CHW effectiveness is their inclusion in the Affordable Care Act as distinct members of the health care team and the Centers for Medicaid and Medicare services recent guidance that allows for reimbursement of preventive services offered by unlicensed professionals such as CHWs. Objective: In response to such historical shifts in healthcare policy, and in partnership with local and state health departments and CHW professional associations, the Arizona Prevention Research Center (AzPRC) aimed to characterize the CHW workforce and assess the attitudes, barriers and impact of the utilization of CHWs among primary care providers and health plans. Methods: A series of quantitative and qualitative surveys and interviews engaged a large national sample of CHWs (N=1600) and a local sample of primary health care providers and health plans (N=150). Results: Approximately 28% (439) of CHWs surveyed nationally work in a clinical setting. Locally, health care providers reported CHW impact on the quality of care for high cost and high-risk patients, including improved access to care and health outcomes. CHWs improved provider efficiency through health systems navigation, health education and social support. Conclusions: CHWs are an effective member of the primary health care team and improve access to care and management of chronic conditions among high-risk high cost populations.