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How Community Health Workers Support Value-Based Care Principles

Community health workers can reduce healthcare utilization by 65 percent, a key principle in driving value-based care.

community health workers

Source: Thinkstock

By Sara Heath

- New data from the Perelman School of Medicine at the University of Pennsylvania has found that community health workers can reduce hospitalizations by 65 percent, helping organizations deliver on value-based care principles.

The research, funded by a $1.9 million grant from the Patient-Centered Outcomes Research Institute (PCORI), looked at how community health workers impact the quality of care patients receive.

By addressing patients’ social needs, which are often referred to as the social determinants of health, the researchers hypothesized that patients could lead healthier lives and have fewer costly interactions with the healthcare system.

The Penn Med researchers implemented a standardized community health worker model entitled IMPaCT (Individualized Management for Patient-Centered Targets). This program aimed to connect high-risk patients with peer supports who can help address social issues and improve patients’ abilities to be healthy.

The researchers introduced this program to 304 patients in a VA health center, a federally-qualified health center (FQHC), and an academic family practice clinic. Just under 300 patients served in a control group receiving traditional primary care.

Overall, those in the intervention group receiving community health support experienced better outcomes. Intervention patients were twice as likely to report high-quality care and spent less time in the hospital. At six months, the intervention group had spent 155 days in the hospital compared to 345 days for the control group. At nine months, those figures totaled at 300 days versus 471.

Lower healthcare utilization is key to cutting health care costs and delivering on value-based care principles, the researchers said.

“Our team is encouraged to report findings supporting the idea that health care organizations can use a standardized community health worker intervention to address socioeconomic factors, improve quality of care and reduce hospitalization,” says study co-author David Grande, an associate professor of Medicine. “The 65 percent reduction in total hospital days is significant when it comes to demonstrating the value for health systems using a standardized intervention like IMPaCT.”

Community health workers have emerged as key players in the value-based care puzzle. These non-clinical healthcare professionals are responsible for supporting patients, addressing patients’ social needs, and driving care coordination. In employing lay-person community health workers for these duties, healthcare organizations can utilize their resources more efficiently while still ensuring patients receive comprehensive care.

The job of a community health worker doesn’t always have to be entirely focused on clinical needs, said one program participant. According to Anthony Davis, a veteran and community health worker at the Crescenz VA Medical Center, using his own experiences to relate to patients helped support the patients.

“We do things that doctors, nurses, and social workers don’t,” Davis said. “I noticed a lot of my patients had PTSD and were socially isolated. I took my time with them and got them to come out each week to social activities like movies or bowling. We even planted an urban garden. After these efforts, you can see the difference in their health.”

It is those shared experiences that make community health workers so successful, experts agree. Separate research published in JAMA Oncology showed that non-clinical healthcare professionals are essential for filling in care gaps and can expand care to patients who otherwise would go without.

“Unlike physicians and nursing staff, navigators are not limited by the traditional model of clinic-based care. They engage patients during clinical encounters with health care professionals and between appointments through frequent telephone communication,” the researchers said in the JAMA Oncology study.

“This patient-centered, preventive, proactive approach has the potential to lead to increased patient activation and earlier management of symptoms, decreasing the likelihood of unplanned admissions or inefficient care.”

The role of the community health worker has yet to become pervasive around the country. Although some healthcare organizations see the benefits of community health workers, others either do not have the financial resources or do not have the staffing bandwidth to create these employment decisions.

As research continues to indicate both the cost and the care quality benefits to hiring community health workers, more organizations are likely to add these positions to their staffing models. However, obstacles related to cost of hiring, staffing, and standardizing these roles need addressing.

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