July 2012 Issue Brief:
Supporting the Current and Future Health Care Workforce
Investing in Community Health Workers
The ACA identified community health workers (CHWs) as important members of the health care workforce. However, long before the ACA was passed in 2010, Blue Cross Blue Shield foundations in Massachusetts and Minnesota recognized CHWs as vital partners in providing health services to poor and underserved communities.
Blue Cross and Blue Shield of Minnesota Foundation (Blue Cross Foundation) has also supported an extensive CHW project for over ten years in order to promote health in underserved communities and strengthen the cultural competence of health and service organizations serving the state’s increasingly diverse population. The efforts have helped to develop partnerships and coalitions that have resulted in impressive concrete outcomes throughout the state. For example, the foundation provided seed funds for the Healthcare Education-Industry Partnership to develop the Minnesota Community Health Worker Alliance, which went on to oversee the development of a statewide standardized curriculum for CHWs offered in the Minnesota State Colleges and Universities System. The curriculum was the first of its kind in the nation and the Alliance is currently exploring how to offer it online in order to expand the training opportunities in the state. The foundation also commissioned the National Fund for Medical Education at the University of California-San Francisco Center for the Health Professions to conduct the first national study of sustainable financing mechanisms for CHWs. Findings from this research showing a positive return on investment for the dollars spent on training and employing CHWs led to 2007 legislation approving the direct hourly reimbursement of CHW services under Medicaid. Minnesota remains the only state that reimburses for CHWs in clinical settings.
Blue Cross Foundation currently funds two additional projects to support CHWs who provide services in Minnesota’s underserved communities. The Deaf Community Health Worker Project focuses on empowering deaf people to become active participants in their own health by assisting immigrants, refugees, senior citizens and cancer survivors with hearing impairments through the use of diagrams and pictures to explain medical information and ensure adherence to recommended care. These CHWs also accompany patients to medical appointments, leading to an estimated preliminary savings of 40 percent from a reduced number of missed appointments due to interpreter services.[i] The second grant is a research project at the Mayo Clinic to explore how CHWs in primary care improve health outcomes for immigrant patients. Results will be available at the end of 2013.
[i] Ancheta J. Bridging barriers, expanding access, improving health. Presentation during National Institute for Health Care Management (NIHCM) Foundation webinar April 5, 2012.