The impact of integrating community health workers into the patient-centered medical home.

Abstract

Establishing patient-centered medical homes (PCMHs) that deliver comprehensive care can be challenging for practices serving diverse populations. Integrating community health workers (CHWs) as members of the care team is one approach to deliver such care; however, little is known about this process. We study an approach of integrating CHWs into PCMHs with predominantly Latino, pediatric asthma patients and examine the impact on care delivery. A case study was conducted to examine the integration of 8 CHWs into 5 PCMHs in an academic medical center located in a large, urban setting. Data associated with referrals to CHW practice-based education and support and to a care coordination program, as well as survey results from providers on the impact of CHWs in PCMHs were collected and analyzed over the study period. More than 750 families of children with asthma received education and support from CHWs from February 2011 through December 2013. The number of referrals to the care coordination program increased 7-fold during this time (P < .001). Of providers surveyed (n = 55), those who reported not referring to care coordination decreased from 22% to 6% and those who reported referring patients to care coordination increased from 67% to 79%. Additionally, 39% of providers reported giving a care plan to patients when prompted by the CHW. CHWs can be successfully integrated into the PCMH care team. They may also impact the identification of high-risk populations for care coordination and delivery of comprehensive care.