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

Yanitza Soto,Samantha Sabo,Heather Dreifuss,Louisa O'Meara,Nancy Wexler,Floribella Redondo,Jill Guernsey De Zapien,Maia Ingram,Heather Carter

doi:10.3389/fpubh.2021.601908

Abstract

Understanding and building organizational capacity for system change and the integration of the Community Health Worker (CHW) workforce within the health scare 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. This collaborative effort was in direct response to emergent state and national CHW workforce policy opportunities, and the shifting health care landscape in Arizona – which merged behavior and physical health. Specifically, and in collaboration with a broad-based, statewide CHW workforce coalition, led by the CHW professional association, we assessed 245 licensed health care professionals with experience working with CHWs and 16 Medicaid-contracted health plan leadership. Our goal was to generate a baseline understanding of the knowledge, attitudes and beliefs these stakeholders held about the integration of CHWs into systems and teams. Our findings demonstrate a high level of organizational readiness and action toward integration of CHWs within the Arizona health care system and care teams. CHWs have emerged as a health care workforce able to enhance the patient experience of care, improve population health, reduce cost of care, and improve the experience of providing care among clinicians and staff.

Highlights

The national expansion of health plans and health-plan contracted provider groups that promote the use of the Community Health Worker (CHW) workforce within clinical care has increased in the last decade
The inclusion of CHWs in multidisciplinary care teams contributes to the efficacy of Patient-Centered Medical Homes (PCMH), Accountable Care Organizations (ACO) and Community Health Teams [4,5,6]
Physicians, Physicians’ Assistants and Nurse Practitioners accounted for 65% (N = 160) of the sample

Summary

Introduction

The national expansion of health plans and health-plan contracted provider groups that promote the use of the Community Health Worker (CHW) workforce within clinical care has increased in the last decade. More markedly with the proliferation of the Quadruple Aim framework, which acknowledges the critical role of the health care team in healthcare transformation [1], CHWs. CHW Integration in Medicaid Systems have emerged as a health care workforce able to enhance the patient experience of care, improve population health, reduce cost of care, and improve the experience of providing care among clinicians and staff [2, 3]. The inclusion of CHWs in multidisciplinary care teams contributes to the efficacy of Patient-Centered Medical Homes (PCMH), Accountable Care Organizations (ACO) and Community Health Teams [4,5,6]. In addition to coordinated care, both ACOs and PCMHs are required to provide routine preventive care and patient education. Movement toward Medicaid financing for value-based purchasing, or health plan reimbursement for patient population outcomes rather than per capita health services, offers yet another opportunity for the integration of CHWs into health systems and as members of the care team

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Conclusion