Hourly Wages and Turnover of Community Health Workers According to US State Certification Policy and Medicaid Reimbursement, 2010-2021

Authors: Tammie M. Jones PhD, MHA, Chanup Jeung PhD, Alex Schulte, Charlotte M. Lewis DrPH, MPH, and Peggy J. Maddox RN, EdD, MSN
Year: 2022
State: NatDoc: National Document
Website link: https://nachw.org/wp-content/uploads/2023/02/Jones-2022-wages-cert-ajph.2022.306965.pdf
Publicly Available: Yes
Certification: Administration - certification boards state health departments etc., CHW role scope of practice, Funding of certification, Lessons learned from other states, National guidance, Process and development, Role of state government, Training and training programs
Evidence Generation: Evidence-based interventions
Policy: General language around CHW WD
Sustainable Financing: How to engage and work with Medicaid, Reimbursement TA for FQHCs Medicaid etc., Results from pilots studies etc. that aren't published in formal literature

The objective of this study was to evaluate the effects of state community health worker (CHW) certification programs and Medicaid reimbursement for CHW services on wages and turnover. A staggered difference-in-differences design was used to compare CHWs in states with and without CHW certification or CHW Medicaid reimbursement policies. Data were derived from the 2010 to 2021 Current Population Survey in the United States. CHW wages increased by $2.42 more per hour in states with certification programs than in states without programs (P = .04). Also, hourly wages increased more among White workers, men, and part-time workers (P = .04). Wages increased by $14.46 in the state with the earliest CHW certification program adoption (P < .01). Neither of the policies assessed had an effect on occupational turnover. CHW wages are higher in states with certification programs. However, wage gaps exist between Whites and non-Whites and between men and women. Federal, state, and employer-based strategies are needed to establish and sustain effective CHW programs to meet the needs of communities experiencing health and access disparities.

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