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September 24, 2017 Greater Hartford Health

Community health workers are worth the money

By Patricia Baker

There are not many certainties in health care during these tumultuous times, but here are a few:

• No matter what happens in Washington, there will be growing pressure on healthcare providers and insurers to control costs.

• Providers will increasingly be held accountable for patients' outcomes.

• Perhaps most importantly, there's a lot of room for improvement in the health of, and the care delivered to, Connecticut residents — particularly people of color.

These dynamics present challenges that are daunting, but not insurmountable. One of the key steps that healthcare providers, insurers and employers can take now is to embrace the use of community health workers as a critical and cost-effective way to improve health.

Community health workers (CHWs) are public health workers who help to bridge the gaps between the doctor's office and patients' lives outside the clinic.

CHWs can identify and help overcome barriers people face to taking care of their health. They make sure patients show up for appointments, access the right care at the right time, have the tools to manage chronic conditions, and can access and afford their medications.

There are many CHWs in Connecticut, often known by other terms, such as health coaches, patient navigators or peer educators.

They can often be found working for hospitals, community health centers, behavioral health clinics and community-based organizations.

CHWs can play a key role in reducing preventable hospitalizations and readmissions – something healthcare organizations will be under increasing pressure to do as payers shift their focus to care quality.

While the Connecticut Health Foundation has provided more than $1 million in grants for CHW programs over the past 17 years, what's been missing is a way to ensure that this critical role can be funded in a sustainable way. We are eager to partner with healthcare organizations interested in pilot projects to test sustainable models.

It could mean hiring CHWs to help diabetic patients get their blood sugar under control – reducing preventable hospitalizations, amputations and premature deaths – as the Mercy health system in Texas has done.

It could mean using CHWs to help frequent emergency department users better address their needs, as the insurer Molina Healthcare did in New Mexico.

In a recent report commissioned by the Foundation, researchers at the University of Massachusetts Medical School's Center for Health Law and Economics identified the above programs as having potential for Connecticut. They are projected to produce savings in direct medical costs that exceed the cost of the program within three years.

For example, the diabetes program, if implemented in Hartford to serve 316 people, would cost $388,000 and save an estimated $435,000.

A new law, Public Act 17-74, puts Connecticut on a path toward certifying CHWs, a key step in ensuring they meet established standards. This can provide confidence to hospitals, physician practices, community organizations and insurers about the workforce.

It's understandable that some healthcare organizations would be wary of spending money on an additional service when cost pressures are forcing cutbacks. However, we at the Foundation view CHWs as a worthwhile investment that will save money and improve health outcomes.

Patricia Baker is the president and CEO of the Connecticut Health Foundation, the state's largest independent health philanthropy.

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