Promote Sustainable Financing Mechanisms Towards Enhancing The Effectiveness Of Important Community Health Workers

“(A) key to advancing new reimbursement models…should be designed to appropriately compensate Community Health Workers (CHWs), support the sustainable integration of CHWs into team-based care, and promote the broad engagement of CHWs by mainstream healthcare providers.

An immediate opportunity is the Centers for Medicare and Medicaid Services’ Preventive Services Rule, which paves the way for state Medicaid programs to reimburse for community-based preventive services provided by personnel other than physicians or licensed practitioners.

Some states, such as Minnesota and Alaska, already reimburse for CHW services through their Medicaid programs. Even where CHWs are not formally reimbursed by the state, some public health plans have moved forward on their own. Alameda Alliance for Health in the San Francisco Bay Area, as well as CareOregon, pays for CHW services. Inland Empire Health Plan in Southern California employs an in-house team of full-time CHWs…” – www.iom.edu/~/media/Files/Perspectives-Files/2015/CommunityHealthWorkers.pdf?la=en

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