Society of Behavioral Medicine (SBM) position statement: SBM supports increased efforts to integrate community health workers into the patient-centered medical home

Abstract

Integrating community health workers (CHWs) into health care systems has been associated with enhanced patient experience, improved population health, and reduced costs and unnecessary utilization of resources.

Integrating Community Health Workers Into Medical Homes

“…5,25,26,32 A sole focus on reimbursement, however, misses other identified obstacles to embracing workforce innovation, including concerns about the risk of hiring a new workforce member, supervision, and a medicalized view of patients.…”

“…3,4,12,[21][22][23] Health authorities have called for expanding interventions by CHWs among clinics serving these populations, and recent policies create a platform for greater community health worker integration. [24][25][26] Researchers have explored the experience of CHWs with integration into care teams and examined how health care delivery systems might be Elizabeth A. Rogers, MD,MAS 1 designed to effectively embed them. [27][28][29][30][31] Experts have outlined implementation barriers (fragmented and disease-specific interventions, lack of clear work protocols, high turnover, variable performance, and a history of low-quality evidence), but argue that these barriers can be overcome through established standards to ensure a skilled CHW workforce, clearly defined roles, concrete implementation strategies, and an expanded scope of reimbursable services to include their services.…”

“…[27][28][29][30][31] Experts have outlined implementation barriers (fragmented and disease-specific interventions, lack of clear work protocols, high turnover, variable performance, and a history of low-quality evidence), but argue that these barriers can be overcome through established standards to ensure a skilled CHW workforce, clearly defined roles, concrete implementation strategies, and an expanded scope of reimbursable services to include their services. 5,6,25,26,32 Little research exists on whether these strategies are sufficient for wide adoption of CHWs within primary care and how clinics make decisions about this adoption.…”

“…[24][25][26] Researchers have explored the experience of CHWs with integration into care teams and examined how health care delivery systems might be 27-31 Experts have outlined implementation barriers (fragmented and disease-specific interventions, lack of clear work protocols, high turnover, variable performance, and a history of low-quality evidence), but argue that these barriers can be overcome through established standards to ensure a skilled CHW workforce, clearly defined roles, concrete implementation strategies, and an expanded scope of reimbursable services to include their services. 5,6,25,26,32 Little research exists on whether these strategies are sufficient for wide adoption of CHWs within primary care and how clinics make decisions about this adoption.Minnesota was the first state to create and offer a statewide competency-based CHW curriculum situated in postsecondary education. 19,33 Since 2009 Minnesota Medicaid has reimbursed diagnosis-related CHW patient education and self-management services.…”

A 6-year update of the health policy and advocacy priorities of the Society of Behavioral Medicine

“…Since 2011, SBM has published 14 health policy briefs (http://www.sbm.org/advocacy/policy-briefs). Of these, 11 have been published in TBM [1][2][3][4][5][6][7][8][9][10][11], 8 have been completed with SIG expert feedback [1-5, 7, 8, 11], and over the last 2 years, 4 have resulted from collaborations with at least one partner organization [7,8,11]. These briefs covered a broad range of topics, such as prevention of childhood obesity [2][3][4], screening and vaccination to prevent cancer [1,7,11], ecigarette policies [9], and reimbursement for peer support in health care [5].…”