Where Is the Break-even Point for Community Health Workers? Using National Data and Local Programmatic Costs to Find the Break-even Point for a Metropolitan Community Health Worker Program

BACKGROUND: Community health worker (CHW) programs take many forms and have been shown to be effective in improving health in several contexts. The extent to which they reduce unnecessary care is not firmly established. OBJECTIVES: This study estimates the number of hospitalizations and emergency department (ED) visits that would need to be avoided to recoup program costs for a CHW program that addressed both medical and social needs. RESEARCH DESIGN: A programmatic cost analysis is conducted using 6 different categories: personnel, training, transportation, equipment, facilities, and administrative costs. First, baseline costs are established for the current program and then estimate the number of avoided ED visits or hospitalizations needed to recoup program costs using national average health care estimates for different patient populations. MEASURES: Data on program costs are taken from administrative program records. Estimates of ED visit and hospitalization costs (or charges in some cases) are taken from the literature. RESULTS: To fully offset program costs, each CHW would need to work with their annual caseload of 150 participants to avoid almost 50 ED visits collectively. If CHW participants also avoided 2 hospitalizations, the number of avoided ED visits needed to offset costs reduces to about 34. CONCLUSIONS: Estimates of avoided visits needed to reach the break-even point are consistent with the literature. The analysis does not take other outcomes of the program from the clients' or workers' perspectives into account, so it is likely an upper bound on the number of avoided visits needed to be cost-effective

Baseline (sea) · Community health · Community health workers · Economics · Emergency department · Environmental health · Health care · Health services · Medical emergency · Metropolitan area · Population · Public health · Diabetes Management and Education · Food Security and Health in Diverse Populations · Medicine · Nursing · Public Health Policies and Education

• Aligning research and practice

  Open Access•Jessica A Williams, Jarron M Saint Onge et al.•Evaluation and Program Planning•2021

  Incluir item

• The exchange and use of cultural and social capital among community health workers in the United States

  Open Access•Jarron M Saint Onge, Onofrio Vox et al.•Sociology of Health & Illness•2021

  Incluir item

• Outcome Effectiveness of Community Health Workers

  Open Access•Susan M Swider•Public Health Nursing•2002

  Incluir item

• Effectiveness of a Community Health Worker Cardiovascular Risk Reduction Program in Public Health and Health Care Settings

  Mori J Krantz, Stephanie M Coronel et al.•American Journal of Public Health•2013

  Incluir item

• Effectiveness of a Community Health Worker Intervention Among African American and Latino Adults With Type 2 Diabetes

  Michael S Spencer, Ann‐Marie Rosland et al.•American Journal of Public Health•2011

  Incluir item

• Evaluation of a Cervical Cancer Control Intervention Using Lay Health Workers for Vietnamese American Women

  Victoria M Taylor, J Carey Jackson et al.•American Journal of Public Health•2010

  Incluir item

• Outcomes and Costs of Community Health Worker Interventions

  Meera Viswanathan, Jennifer L Kraschnewski et al.•Medical Care•2010

  Incluir item

• Benchmarks for Reducing Emergency Department Visits and Hospitalizations Through Community Health Workers Integrated Into Primary Care

  Sanjay Basu, Henry Jack et al.•Medical Care•2017

  Incluir item