Integrating Community Health Workers Within Patient Protection and Affordable Care Act Implementation
Published Date:2015 Jan-Feb
Source:J Public Health Manag Pract. 21(1):42-50.
Pubmed Central ID:PMC4416641
Funding:1U48DP001904-01/DP/NCCDPHP CDC HHS/United States
1U48DP006008-01/DP/NCCDPHP CDC HHS/United States
2P60MD000538-10/MD/NIMHD NIH HHS/United States
P60 MD000538/MD/NIMHD NIH HHS/United States
R01 AG046149/AG/NIA NIH HHS/United States
R01 CA175329/CA/NCI NIH HHS/United States
R01 HL085567/HL/NHLBI NIH HHS/United States
R01 MD007716/MD/NIMHD NIH HHS/United States
R25 HL105444/HL/NHLBI NIH HHS/United States
U01 CA086322/CA/NCI NIH HHS/United States
U48 DP001904/DP/NCCDPHP CDC HHS/United States
U48 DP005008/DP/NCCDPHP CDC HHS/United States
U58 DP001022/DP/NCCDPHP CDC HHS/United States
U58 DP004685/DP/NCCDPHP CDC HHS/United States
U58 DP005621/DP/NCCDPHP CDC HHS/United States
U58DP001022/DP/NCCDPHP CDC HHS/United States
UL1 TR000038/TR/NCATS NIH HHS/United States
UL1TR000038/TR/NCATS NIH HHS/United States
The Patient Protection and Affordable Care Act’s (PPACA) emphasis on community-based initiatives affords a unique opportunity to disseminate and scale up evidence-based community health worker (CHW) models that integrate CHWs within health care delivery teams and programs. Community health workers have unique access and local knowledge that can inform program development and evaluation, improve service delivery and care coordination, and expand health care access. As a member of the PPACA-defined health care workforce, CHWs have the potential to positively impact numerous programs and reduce costs.
This article discusses different strategies for integrating CHW models within PPACA implementation through facilitated enrollment strategies, patient-centered medical homes, coordination and expansion of health information technology (HIT) efforts, and also discusses payment options for such integration.
Title V of the PPACA outlines a plan to improve access to and delivery of health care services for all individuals, particularly low-income, underserved, uninsured, minority, health disparity, and rural populations. Community health workers’ role as trusted community leaders can facilitate accurate data collection, program enrollment, and provision of culturally and linguistically appropriate, patient- and family-centered care. Because CHWs already support disease management and care coordination services, they will be critical to delivering and expanding patient-centered medical homes and Health Home services, especially for communities that suffer disproportionately from multiple chronic diseases. Community health workers’ unique expertise in conducting outreach make them well positioned to help enroll people in Medicaid or insurance offered by Health Benefit Exchanges. New payment models provide opportunities to fund and sustain CHWs.
Community health workers can support the effective implementation of PPACA if the capacity and potential of CHWs to serve as cultural brokers and bridges among medically underserved communities and health care delivery systems is fully tapped. Patient Protection and Affordable Care Act and current payment structures provide an unprecedented and important vehicle for integrating and sustaining CHWs as part of these new delivery and enrollment models.
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