Community Health Worker Intervention to Decrease Substance Use Disorder Readmissions in Medicaid-Enrolled Adults

Community Health Workers (CHW) are individuals with an understanding of the communities they serve, employed within healthcare and human service systems to assess health and social needs of community members and connect individuals to needed services. In this study, CHWs employed by a behavioral health managed care organization (BHMCO) were trained in a care coordination intervention to address reasons for substance use disorder (SUD) admission, health-related determinants, and motivation for ongoing treatment, with the goal to improve care and reduce readmissions. This observational cohort study included 865 Medicaid-enrolled adults with SUD hospitalization or residential service in 2021-2024; 593 individuals (68.6%) received the CHW Intervention. Outcomes included the BHMCO's paid service claims. Rate of readmission for those receiving the intervention was low (5.7%); approximately half (49.8%) received follow up services within 30 days of admission. Models adjusting for differences between those with and without the intervention (n = 272) showed higher odds for 7- and 30-day follow up for those with CHW contact. The present effort shows positive impact of the work of CHWs when part of a behavioral health treatment team on quality of care for individuals with SUD.