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Community Health Worker Program Increased Access to Outpatient Care

Research May 9, 2023

Community Health Workers (CHWs) aim to improve the health of community members through services such as health education, referrals to community resources, language interpretation and translation, informal counseling, and patient advocacy.

CHWs have been shown to improve outcomes when working with people who have specific chronic conditions, but less is known about the impact of CHW programs on general healthcare utilization and spending.

This study evaluated outcomes for people who participated in a CHW program between May 2018 and March 2020. The CHW program, operated by an Elevance Health-affiliated Medicaid plan, included assessment of social needs, referral to community resources, care coordination, transportation, accompanying members to medical visits, and translation services for people in a historically disadvantaged population.

Findings: The researchers found that for the participants, there were significant increases in outpatient office visits (18%), including a 21% increase in primary care visits, relative to a comparison group. The group of people participating in the CHW program was also six times more likely to access care via telehealth at the beginning of the COVID pandemic, indicating that the program may have helped address known disparities in use of technology. Increased telehealth and primary care visits continued 18 months after the CHW program ended.

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Among program participants, there were:

18% more outpatient office visits
 

21% more primary care visits

What’s Next: The fact that outpatient visits increased during the CHW program demonstrates that health plans can design and implement CHW programs to address social drivers of health and meaningfully impact healthcare utilization for people in hard-to-reach populations.

“It was encouraging to see that the health plan was successful in increasing access to outpatient care, and primary care in particular, for people in a hard-to-reach population. Health plans are well positioned to lead community health efforts due to their widespread geographic presence and incentives to keep patients healthy and out of the hospital,” said Aliza S. Gordon, director of research, Elevance Health Public Policy Institute.

Methodology: This retrospective cohort study used data from adult health plan members who participated in the CHW intervention (N=538 participants) compared to those who were identified as eligible for participation but were unable to be reached (N=435 nonparticipants). Outcomes measured included scheduled and emergency inpatient admissions, emergency department visits, outpatient visits, and healthcare spending. The follow-up period for all outcome measures was six months. Using generalized linear models, six-month change scores were regressed on baseline characteristics to adjust for between-group differences (e.g., age, sex, comorbidities) and an indicator for group.

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