The presenter will share some thinking about the support by managed care organizations (mco’s) of community health workers (chw’s) from his experience with Kaiser Permanente (KP), an integrated, non-profit mco. The most prevalent use has been KP’s employment of chw’s for the care of its Medicaid members in Hawaii and Oregon. These chw’s have not been perceived as integral to KP’s basic healthcare delivery system. KP uses its community service dollars to fund the use of chw’s by community clinics and other non-profit providers, but this is rarely ongoing support and is seldom connected to KP’s care of its own members. In two recent examples, KP is evaluating the use of chw’s in the care of its members, not limited to its Medicaid members. In both cases, the chw’s are employed by KP itself. In one, the chw is herself from the recovery community and provides home visitation and support to substance-using pregnant members who have entered prenatal care late and/or dropped out of drug treatment. In the other, seniors are employed and trained as chw’s to provide visitation and support to home-bound senior members. Additional such pilots by KP will likely occur, including those that test the use of chw’s in the management of members with chronic conditions.
Learning Objectives: Attendees will understand how to think about the use of community health workers within managed care settings, their use within Medicaid managed care contracts and their use within managed care organizations' medical care of its basic enrolled populations
Keywords: Community Health Advisor, Managed Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Kaiser Permanente, California Division
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.