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Billing Medicaid for Community Health Worker Services: The Promise, Pitfalls, and Path Forward
Mechelle R Sanders1, Kevin Fiscella1
1Department of Family Medicine Family Medicine Research Programs University of Rochester.
Abstract:
This commentary examines the implications of the Community Health Worker (CHW) Access Act introduced by Congress. If passed, primary care practices would be able to receive reimbursement for CHW services. CHWs are lay members of the community that help people address the social determinants of health, understand their health, and get the health care they need, especially in communities where resources are scarce. They have been shown to improve health outcomes, yet many serve in unpaid positions and their services have not been readily reimbursable in the healthcare system. We highlight the potential of the Bill to facilitate the uptake of CHWs in primary care. This is particularly important at a time when the provision of primary care is scarce. We examine the potential and pitfalls of the Bill and recommend implementation strategies to support the uptake of CHWs into primary care. This commentary aims to inform stakeholders about the Bill's broader impact on primary care and future CHW sustainability.
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