Community Health Workers in Enhanced Care Management and In Lieu of Services: A Model of Care Resource



Authors: California Health Care Foundation
Year: 2021
State: CA
Website link: https://www.chcf.org/wp-content/uploads/2021/10/CHWPsInCalAIMsECMAndILOS.pdf
Publicly Available: Yes
Billing and Reimbursement:
Certification:
Evidence Generation:
Policy:
Sustainable Financing: Engaging state partners in general, General other, How to engage and work with Medicaid, Billing/CPT codes, Education to HC orgs on payment options bundled etc., MCO or bundled payment reimbursement models, Reimbursement TA for FQHCs Medicaid etc.
Workforce Development: CHW training programs (not cert.), General other (including mention of “employment practices”), Promotores

This document was developed as a resource for Managed Care Plans completing the CalAIM Model of Care Template. The chart that follows indicates the potential role that community health workers (CHWs) contracted via established local organizations can play in the Enhanced Care Management (ECM) Core Services and In Lieu Of Services (ILOS).

This document provides insight into:

  • ►  how CHWs can support outcomes, produce data, and build relationships necessary for program delivery and reporting
  • ►  how CHW services align with billable encounters


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