State Approaches to Community Health Worker Financing through Medicaid State Plan Amendments

This brief provides an overview of recent developments in Medicaid State Plan Amendments (SPAs). States can use SPAs to shape Medicaid benefits to address enrollee needs and reimburse for CHW services as part of a sustainable financing approach. With a SPA, benefits must be offered statewide and without targeting populations. Twenty or more states have also used Section 1115 demonstration waivers and Medicaid managed care organization (MCO) contracts for similar purposes — each of these approaches has opportunities and limitations.