Keywords
1. Community health workers
2. Long-term care services
3. Home and community-based services
4. Medicaid beneficiaries
5. Health service navigation
A recent study has emerged as a beacon of hope for individuals struggling to navigate the labyrinth of home and community-based long-term care (HCBS) services. The study, published in the “Home Health Care Services Quarterly,” has highlighted the pivotal role of community health workers (CHWs) in identifying and assisting those in need of such services, thus potentially revolutionizing the access to care for many.
Background
Traditional approaches to outreach for home and community-based long-term care (LTC) services have often been passive, relying on individuals to seek out and access information and support. This method has left many consumers, especially Medicaid beneficiaries, in the dark about the services available to them. The lack of information has resulted in underutilization of HCBS and over-reliance on nursing home care, which is generally less preferred by consumers. It has become increasingly vital to identify more proactive and effective methods to bridge this information gap and facilitate the utilization of HCBS.
The Invaluable Role of Community Health Workers
The study by Felix Holly C. et al. (2020), titled “Are community health workers more effective in identifying persons in need of home and community-based long-term services than standard-passive approaches?” explores the role of CHWs in this context. CHWs are public health allies who have a close understanding of the communities they serve, often sharing ethnicity, language, socioeconomic status, and life experiences with the community members.
DOI: 10.1080/01621424.2019.1604461
The researchers compared the impact of CHWs as a proactive approach to the standard strategies in connecting individuals with HCBS. The findings are groundbreaking; they illustrate that CHWs are remarkably adept at identifying individuals with greater needs and assisting them in accessing a broader range of HCBS services compared to standard methods.
Impact on Nursing Home Care Usage
Perhaps most notably, the intervention of CHWs led to a significant reduction in the need for nursing home care services. The study found that HCBS beneficiaries who were aided by CHWs were five times less likely to use nursing home services, even though they had poorer health statuses compared to those who were not helped by CHWs. This suggests that CHWs do not merely shuffle services around; they facilitate access to appropriate care that effectively meets the health needs of the beneficiaries.
Evidence of Effectiveness
The study provides substantial evidence supporting the efficacy of CHWs in improving awareness and navigation of HCBS. It underscores the importance of adopting proactive and targeted approaches to outreach.
The study was authored by Felix Holly C., Ali Mir M., Bird T Mac TM., Cottoms Naomi N., and Stewart M Kate MK. from the Fay W. Boozman College of Public Health at the University of Arkansas for Medical Sciences, alongside Cottoms Naomi N. from the Tri-County Rural Health Network in Helena-West Helena, AR, USA.
References
1. Kangovi, S., Mitra, N., Grande, D., White, M. L., McCollum, S., Sellman, J., … & Long, J. A. (2014). Community health worker support for disadvantaged patients with multiple chronic diseases: a randomized clinical trial. American journal of public health, 104(10), e30-e39. DOI: 10.2105/AJPH.2014.302180
2. Kim, K., Choi, J. S., Choi, E., Nieman, C. L., Joo, J. H., Lin, F. R., Gitlin, L. N., & Han, H. R. (2016). Effects of community-based health worker interventions to improve chronic disease management and care among vulnerable populations: a systematic review. American journal of public health, 106(4), e3-e28. DOI: 10.2105/AJPH.2015.302987
3. Fedder, D. O., Chang, R. J., Curry, S., & Nichols, G. (2003). The effectiveness of a community health worker outreach program on healthcare utilization of west Baltimore City Medicaid patients with diabetes, with or without hypertension. Ethnicity & disease, 13(1), 22-27. DOI: 10.18865/ed.13.1.22
4. Allen, C. G., Brownstein, J. N., Jayapaul-Philip, B., Matos, S., & Mirambeau, A. (2015). Strengthening the Effectiveness of State-Level Community Health Worker Initiatives Through Ambulatory Care Partnerships. Journal of Ambulatory Care Management, 38 (3), 254-262. DOI: 10.1097/JAC.0000000000000086
5. Findley, S. E., Matos, S., Hicks, A. L., Chang, J., & Reich, D. (2014). Community health worker integration into the health care team accomplishes the Triple Aim in a patient-centered medical home: A Bronx tale. Journal of ambulatory care management, 37(1), 82-91. DOI: 10.1097/JAC.0000000000000006
The Findings’ Implications
The findings from the study conducted by Felix Holly C. et al. have significant implications for public health policy and the structuring of outreach strategies for home and community-based LTC services. They emphasize the necessity for community-centric, proactive, and personalized approaches to healthcare service delivery. Enlisting CHWs in service awareness and navigation may not only improve outcomes for Medicaid beneficiaries but could also result in cost savings as it reduces the reliance on more expensive institutional care options.
Conclusion
The compelling findings of the study are a testament to the power of community engagement and the untapped potential of CHWs as agents of change in the healthcare system. They provide a strong case for the expansion of CHW programs and the integration of these vital workers into the healthcare workforce to ensure all individuals, regardless of socioeconomic status, have access to the care they need and prefer.
Policy makers, healthcare providers, and community organizations can no longer ignore the evidence of the effectiveness of community health workers in the targeted delivery of healthcare services. The study serves as a call to action to capitalize on the unique position that CHWs hold within communities to improve healthcare access, reduce the burden on traditional healthcare settings, and empower consumers to receive care that aligns with their needs and values.