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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

Bibliographic Data

ID9105056
AuthorsTami Gurley‐calvez (University of Kansas), Tami Gurley-Calvez, Jessica A Williams (0000-0002-8195-1355, University of Kansas, corresponding author), Jessica A R Williams
Year2020
Volume58
Issue4
Pages314-319
Publication date2020-04-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001273
PMID32197027
OpenAlexW2995454114
LanguageEN
Citations received2
References cited24

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

  • 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

  • Outcome Effectiveness of Community Health Workers

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

  • 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

  • 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

  • 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

  • Outcomes and Costs of Community Health Worker Interventions

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

  • 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

Unique citing works2
Citations per year0,4
Citation span2021 - 2021 (1)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 2
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