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Society of Behavioral Medicine (SBM) position statement: SBM supports increased efforts to integrate community health workers into the patient-centered medical home

Year:
2015
State:
NatDoc: National Document
Website Link:
Publicly Available:
Yes
Billing and Reimbursement:
Certification:
CHW role scope of practice, Competencies
Evidence Generation:
Documentation of how CHWs can work within care teams
Policy:
Building partnerships, General language around CHW WD, MCO contract language and reimbursement models
Sustainable Financing:​
Expand evidence base, Including community-based CHWs, Evidence-based interventions, White papers
Workforce Development:
Chronic Disease, Data sharing between social services and clinical teams, General other (including mention of “employment practices”), National endorsement/stance on CHWs

Summary

Integrating community health workers (CHWs) into health care systems has been associated with enhanced patient experience, improved population health, and reduced costs and unnecessary utilization of resources. Under the Affordable Care Act (ACA), care provided by CHWs is eligible for reimbursement. However, optimal integration of CHWs into health care requires purposeful implementation. This health policy brief is focused on the benefits of integrating CHWs specifically into the patient-centered medical home (PCMH). CHWs in the PCMH can serve as primary providers of culturally relevant information and advocacy, assist providers in understanding the influence of patients’ environment on disease management, and enhance motivation for self-care management among patients with chronic diseases. Despite the important role of CHWs, there are some barriers to integration into existing systems of care. The Society of Behavioral Medicine (SBM) recommends overcoming these barriers by establishing standards that ensure a skilled CHW work- force, clearly defining roles for CHWs, and expanding the scope of reimbursable prevention and primary care services to include those provided by CHWs.