Evidence-Based Community Health Worker Program Addresses Unmet Social Needs And Generates Positive Return On Investment

Abstract

Interventions that address socioeconomic determinants of health are receiving considerable attention from policy makers and health care executives. The interest is fueled in part by expected returns on investment. However, many current estimates of returns on investment are likely overestimated, because they are based on pre-post study designs that are susceptible to regression to the mean. We present a return-on-investment analysis that is based on a randomized controlled trial of Individualized Management for Patient-Centered Targets (IMPaCT), a standardized community health worker intervention that addresses unmet social needs for disadvantaged people. We found that every dollar invested in the intervention would return $2.47 to an average Medicaid payer within the fiscal year.

Community‐Based Doulas and COVID‐19: Addressing Structural and Institutional Barriers to Maternal Health Equity

“…Community‐based doulas typically provide frequent in‐home visits, as well as services similar to those provided by community health workers: helping patients access social services (e.g., subsidized housing, nutrition assistance programs, intimate partner violence interventions) and navigate the complex components of care during and after pregnancy, and bridging communication divides between providers and patients 22,51,52 . While randomized controlled trials assessing the impact of community‐based doulas on birth outcomes are lacking, there is a substantial body of high‐quality evidence supporting the role of community health workers in improving health outcomes among historically marginalized populations 53–56 …”

“…22,51,52 While randomized controlled trials assessing the impact of community-based doulas on birth outcomes are lacking, there is a substantial body of highquality evidence supporting the role of community health workers in improving health outcomes among historically marginalized populations. [53][54][55][56] A 2019 analysis of several community-based doula programs compared health outcomes between a racially and ethnically diverse sample (47% Hispanic, 33% Black) of 592 low-income individuals who received doula services and a comparison sample of participants from the population-based Pregnancy Risk Assessment Monitoring System (PRAMS). 20 Compared with their counterparts in the PRAMS group, Black mothers enrolled in communitybased doula programs were more likely to be exclusively breastfeeding at six weeks (71% vs. 56%), three months (52% vs. 38%) and six months (39% vs. 7%).…”

Network-Based Delivery and Sustainment of Evidence-Based Prevention in Community-Clinical Partnerships Addressing Health Equity: A Qualitative Exploration

“…The perception that for some partnerships, clinical partners did not place sufficient value on services delivered by non-physician staff (including CHWs) or through community-based organizations is a challenge to a referral-based program and more broadly to a sense of trust, reciprocity, and joint action within a partnership. Service delivery by CHWs—particularly in the context of care delivery by multidisciplinary teams—provides an important opportunity to improve health equity and reduce healthcare costs to payers ( 52 , 53 ). The network contributions identified in this study can serve as a useful starting point for defining relationships in quantitative social network analyses to describe the functioning and impact of community-clinical partnerships delivering preventive EBPs.…”

Effects of a standardized community health worker intervention on hospitalization among disadvantaged patients with multiple chronic conditions: A pooled analysis of three clinical trials

“…We estimate that the average cost of the CHW intervention across all three trials was approximately $1499 per patient, per year (Table ). A detailed analysis of expenditures and cost savings associated with the IMPaCT CHW intervention, using data from Trial 2, has been reported elsewhere 20 …”