Leveraging Medicaid to Support Community Health Workers and Address Health-Related Social Needs
Leveraging Medicaid to Support Community Health Workers and Address Health-Related Social Needs This conversation dives into the role community health workers play in improving public health and how Medicaid funding can support them. 20:13 PH Conversations Series - Leveraging Medicaid to Support Community Health workers and Address Health-Related Social Needs Across the nation, states are exploring opportunities to improve population health by integrating community health workers (CHWs) into the health care workforce. CHWs are public health workers who typically have lived experience and personal connections with the communities they serve. Through these connections, CHWs build trust with community members and serve as crucial links between health systems and marginalized communities. CHWs are vital to addressing health-related social needs (HRSN) and play critical roles in achieving more equitable care across the nation. CHWs may work in clinical and community-based settings under a range of titles, including promotores. CHWs provide many different services and assist clients in navigating resources to support their needs. For example, CHWs can conduct outreach and education, and link people to state and federal benefit programs. State Medicaid agencies and state/territorial health agencies can support the provision of CHW services through collaboration and cross agency-partnerships between public health and Medicaid agencies. These partnerships are particularly salient as state Medicaid agencies begin covering more HRSN services, related HRSN case management, and CHW-provided services through Section 1115 demonstrations and state plan amendments (SPAs). Section 1115 demonstrations, which allow states to test new policies to support Medicaid members and their needs, can fund state pilots for Medicaid-funded CHW programs. Approximately 20 of 64 approved 1115 demonstrations related to HRSN and five states have used 1115 demonstrations to support CHWs. The Centers for Medicare and Medicaid Services’ new 1115 demonstration opportunity on HRSN allows states to invest in CHW certification programs, among other workforce development infrastructure investments. SPAs are another pathway to create sustainable funding for CHW programs. To date, Centers for Medicare and Medicaid Services has approved SPAs to cover CHW services as formal Medicaid benefits in nine states, including Louisiana and California. To learn more about the financing mechanisms states can use to integrate CHW services into the health care system—and how state/territorial health agencies can support Medicaid in these efforts—ASTHO spoke with Diana Crumley, JD, MPAff, Former Associate Director of Delivery System Reform at the Center for Health Care Strategies. Listen to an abbreviated version of the discussion below. Show Notes Article Authors Jahira Sterling, Center for Health Care Strategies Madison Hluchan, ASTHO Interviewer Jennifer Jean-Pierre, Director, Content Development and Communications, ASTHO Guest Diana Crumley, JD, MPAff, Former Associate Director of Delivery System Reform, Center for Health Care Strategies Resource ASTHOBrief: Leveraging Medicaid to Support Community Health Workers PHC Podcast Transcript - Leveraging Medicaid to Support Community Health Workers and Address Health-Related Social Needs website yes