How Community Health Workers Can Affect Health Care

Authors: Graddy R and Fingerhood M
Year: 2018
State: NatDoc: National Document
Website link:
Publicly Available: No
Certification: CHW role scope of practice
Evidence Generation: All, Documentation of how CHWs can work within care teams, Evidence-based interventions, ROI and bundled payment successes/challenges
Sustainable Financing: Expand evidence base, Education to HC orgs on payment options bundled etc., Evidence-based interventions, ROI and bundled payment successes/challenges
Workforce Development: Chronic Disease, Data sharing between social services and clinical teams, General other (including mention of “employment practices”)

In this issue of JAMA Internal Medicine, Kangovi et al build on their previously published work with the IMPaCT intervention, a standardized program that applies a specific tool-box and strategy across a variety of settings. The consistency of IMPaCT is a strength that is comparable with many other interventions that have differing definitions of CHWs and heterogeneous metrics for success.

Having demonstrated improvements in health-related outcomes among inpatients and outpatients at 2 academic medical centers via IMPaCT, the current study looks at similar outpatient-focused health improvements in a greater diversity of primary care sites: academic medical center, federally qualified health center, and Veterans Affairs facility. The authors report mixed results. The primary outcome measure of self-rated physical health slightly worsened, although this was not statistically significant and no change in disease-related quality metrics was observed; the secondary outcomes of hospitalizations and patient-reported receipt of high-quality primary care improved favorably in the intervention group.