Billing Medicaid for Community Health Worker Services: The Promise, Pitfalls, and Path Forward

Area of Science:

• Public Health
• Healthcare Policy

Background:

• Community Health Workers (CHWs) address social determinants of health and improve outcomes.
• CHW services are often unpaid and lack healthcare reimbursement.
• Primary care is currently scarce, increasing the need for accessible health support.

Purpose of the Study:

• To examine the implications of the proposed Community Health Worker (CHW) Access Act.
• To highlight the potential of the Bill to facilitate CHW integration into primary care.
• To inform stakeholders about the Bill's impact on primary care and CHW sustainability.

Main Methods:

• Commentary analyzing proposed legislation.
• Review of CHW roles and impact on health outcomes.
• Discussion of potential benefits and challenges of the Bill.

Main Results:

• The CHW Access Act proposes reimbursement for CHW services in primary care.
• Successful implementation could increase CHW utilization, particularly in underserved areas.
• The Bill presents opportunities and potential pitfalls for CHW integration.

Conclusions:

• The CHW Access Act has the potential to significantly impact primary care delivery and CHW workforce sustainability.
• Strategic implementation is crucial to maximize the benefits of CHW reimbursement.
• Policy changes are needed to support CHWs in addressing health disparities.