Community Health Outreach Worker Project

This data analysis plan, based on five years of Medicaid paid claims, will concentrate on two groups: adults with physical disabilities 18 through 64 years of age; and persons 65 years of age and older. It seeks to meet three goals: To justify the proposed demonstration waiver based on projected cost savings to Medicaid for […]

A Community Participatory Approach to Identify Common Evaluation Indicators for Community Health Worker Practice

Substantial evidence supports community health workers’ (CHWs) contributions to improving health and reducing inequities. Common evaluation indicators can strengthen the evidence base and support the profession. We describe the development of a 6-year community–academic partnership to identify common CHW process and outcome indicators. Methods include interviews, focus groups and a survey conducted in Michigan, a […]

RI Medicaid: Community Health Workers

The Rhode Island Executive Office of Health and Human Services (EOHHS) partners with Gainwell Technologies as its Fiscal Agent to process the state’s Medicaid Program claims, to enroll and train providers, and perform other duties to fulfill State and Federal requirements. EOHHS has the sole responsibility for formatting program policy and procedures. The purpose of […]

RI “Collateral” Services

This document details Rhode Island’s definition of “collateral” services, CHW services that do not take place in the presence of a client.

Establishing a health profession: What oncology patient navigators can learn from the National Association of Community Health Workers

Persons who identify as community health workers (CHWs) may hold other titles and/or certifications, including the title of patient navigator (PN). PN roles first emerged from Dr. Harold Freeman’s initiative at Harlem Hospital as a strategy to reduce disparities in access to health care, whereas CHW roles extend beyond health systems and are predominantly found […]

Organizational Readiness for Community Health Worker Workforce Integration Among Medicaid Contracted Health Plans and Provider Networks: An Arizona Case Study

Understanding and building organizational capacity for system change and the integration of the Community Health Worker (CHW) workforce within the healthcare sector requires a supportive organizational culture among sector leaders and providers. The aim of this mixed-methods study was to assess organizational readiness for CHW workforce integration into Arizona Medicaid health systems and care teams. […]

Community Health Worker Services

This document on South Dakota Medicaid Billing and Policy outlines various elements of the CHW reimbursement process, including the eligible providers, eligible recipients, covered services and limits, approved curriculums, and reimbursement and claim instructions.

CHW Reimbursement Model: South Dakota

This presentation outlines South Dakota’s model for reimbursing CHWs, including South Dakota Medicaid’s definition of CHW scope of services, reimbursement rates, training programs, an overview of South Dakota’s Community Health Worker Collaborative, South Dakota’s CHW Planning and Assessment Toolkit, and planned next steps.