Health Plans

Why Community Health Workers?
News, Case Studies & Research
Products to Support Health Plans

Community Health Workers and Health Plans

Community Health Workers can work to address a variety of health issues, and they take many different approaches to promoting health. Community Health Workers and Community Health Worker programs can support health plans in accomplishing the following goals:
  • Address social determinants of health by referring patients to complimentary and supportive services such as housing, food, transportation, or legal assistance.
  • Provide support and personalized attention to reduce hospital readmission in high-risk populations and improve post-hospital outcomes.
  • Improve health outcomes by helping to ensure that patients understand and follow treatment plans and take prescribed medications correctly.
  • Supporting disease self-management strategies and assisting with individual goal setting and tracking progress.

Why Community Health Workers?

As part of a multi-disciplinary team, Community Health Worker programs “can contribute to reductions in costs to health systems through reducing patient use of costlier care options, such as emergency departments and hospitals.”*
Community Health Workers are uniquely qualified to provide high-touch support to the communities they serve. At Molina Healthcare Community Connector Program used Community Health Workers to target members with “high-cost utilization patterns, complex medical or behavioral health needs, or chronic conditions” and provided in-person engagement and personalized strategies to achieve targeted outcomes. A six-month pilot of this program “resulted in a return on investment of 4:1 when comparing the six-month study-period data with data for the six months preceding and following the intervention.”*
Similarly, a Health Navigator Program at Inland Empire Health Plan used a Community Health Worker home-visitation model to help “connect members with primary care physicians and reduce avoidable emergency department utilization“. Over the course of three years, the program contributed to a 42% decrease in avoidable emergency department visits.*
Studies have found Community Health Worker programs to be effective in promoting cost-effective care “through increasing patients’ use of preventive services, foregoing the use of more resource-intensive services, and helping individuals adopt positive health behaviors in the management of chronic conditions”.*

News, Case Studies & Research

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The New Math in Healthcare: Make money by saving money
Including Community Health Workers in these types of program can help to ensure that the right patients are enrolled and that they receive the personalized support they need to see results.
Promotora2
Rhode Island Home-Care Program Predicts Medicaid Cost Savings Exceeding $2.7M
Community Health Workers as part of an integrated care team can help reduce hospital visits while providing in-home patient assistance.

Products to Support Health Plans

The following are products that we feel are particularly useful tools for Health Plans, however, if you aren’t finding what you are looking for, please take a look at our complete product list.
Consulting Services
Training Services
  • Community Health Worker Core Competencies Training: Whether you are ready to launch your Community Health Worker program or want to reinforce the skills of Community Health Workers in an existing program, these training modules cover key knowledge areas to prepare Community Health Workers for success in a range of settings.
  • Community Health Worker Program-Specific Training: Pick the Community Health Worker program focus that matches your goals and we provide all the training you need to get started.
  • Supervisor Essential Skills: These training modules provide the skills needed to design, evaluate, and supervise Community Health Worker programs.
  • Administrator Training: We offer a range of in-depth training modules on Community Health Worker programs, Community Assessments and Strategic Planning to provide administrators with the tools that they need to make high-level organizational decisions.
Program Design & Implementation Services


*Taking Innovation to Scale: Community Health Workers, Promotores, and the Triple Aim, California Health Workforce Alliance.