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

Shari L Hutchison1, Donna E Mengle2, Irina O Karpov2

  • 1Community Care Behavioral Health Organization of the UPMC Insurance Services, Pittsburgh, USA. hutchisons@ccbh.com.

Community Mental Health Journal
|June 27, 2026
PubMed
Summary
This summary is machine-generated.

Community Health Workers (CHW) improved care for individuals with substance use disorder (SUD). CHW intervention was linked to lower readmission rates and increased follow-up care, enhancing treatment quality.

Keywords:
Managed careMedicaidReadmissionSocial determinantsSubstance use disorder

Related Experiment Videos

Area of Science:

  • Public Health
  • Behavioral Health
  • Healthcare Management

Background:

  • Community Health Workers (CHW) bridge healthcare and social services, assessing needs and connecting individuals to resources.
  • Substance Use Disorder (SUD) treatment requires integrated care to address complex determinants and improve patient outcomes.
  • Behavioral health managed care organizations (BHMCO) play a crucial role in coordinating care for individuals with SUD.

Purpose of the Study:

  • To evaluate the impact of a care coordination intervention delivered by CHWs on the quality of care for adults with SUD.
  • To assess whether CHW intervention reduces readmission rates and improves follow-up service utilization for individuals with SUD.

Main Methods:

  • Observational cohort study of 865 Medicaid-enrolled adults with SUD hospitalization or residential service (2021-2024).
  • Comparison of outcomes between individuals who received the CHW intervention (n=593) and those who did not (n=272).
  • Analysis of paid service claims to determine readmission rates and follow-up service utilization within 7 and 30 days.

Main Results:

  • The CHW intervention group showed a low readmission rate of 5.7%.
  • Approximately half (49.8%) of intervention recipients received follow-up services within 30 days.
  • Adjusted models indicated higher odds of 7- and 30-day follow-up for individuals with CHW contact.

Conclusions:

  • CHWs integrated into behavioral health treatment teams positively impact the quality of care for individuals with SUD.
  • CHW interventions are effective in improving care coordination and reducing readmissions for SUD patients.
  • CHW support enhances continuity of care and follow-up services, crucial for sustained recovery.