Success with CHWs Asthma

Lower costs

01dancingKidsMany providers, health plans and policymakers are particularly interested in the financial benefits of Community Health Worker (CHW) strategies related to overuse, underuse and misuse of health services. Successful examples include reduction in preventable hospital readmissions as well as avoidable emergency room visits.

In addition, increasing the appropriate use of primary care and preventive services can lead to early detection and timely treatment of potentially costly health conditions. And as care systems and local public health agencies shift to team-based models, the introduction of CHWs can improve health care cultural competence, increase patient satisfaction and demonstrate a sustainable staffing model where everyone is working at the top of her/his license.

The following articles provide examples of Community Health Worker (CHW) cost-effectiveness and ROI.

Asthma

In Home is Where the Triggers Are: Increasing Asthma Control by Improving the Home Environment (2010), author James Krieger, MD, notes that a recent cost-effectiveness analysis concluded that home visits have a return on investment of 5.3–14.0 and a cost $12–$57 per symptom-free day gained.

See also Dr. Krieger’s webinar on Seattle – King County’s Healthy Homes I and II projects.

A Community-Based Asthma Management Program: Effects on Resource Utilization and Quality of Life (PDF), which profiles a CHW asthma intervention in Hawaii, shows a decline in emergency room visits and increased quality of life. In one phase of the study, asthma-related per capita charges decreased from $735 to $181.

CHW ROI in other health conditions

Social Return on Investment: CHWs in Cancer Research (PDF)Wilder Research Center’s 2012 cost-benefit analysis of CHW services in cancer outreach found that for every dollar invested in CHWs, society receives $2.30 in return in benefits, a return of more than 200%. 

The Effectiveness of a Community Health Worker Outreach Program on Healthcare Utilization of West Baltimore City Medicaid Patients with Diabetes, with or without Hypertension (PDF) shows that a CHW intervention program resulted in average savings of $2,245 per patient, and a total savings of $262,080 for 117 patients, along with improved quality of life.

Measuring Return on Investment of Outreach by Community Health Workers (PDF), a Denver health study of 590 men in a CHW case management intervention, shows increased use of primary and specialty care, and reduced use of urgent care, inpatient and outpatient behavioral health care use. The return on investment (program costs vs. overall reduced costs of care) was 2.28:1.

In Return on investment from employment of CHWs, author Carl Rush points out that there is a growing body of published research on the effectiveness of CHWs Based on a review of current studies, he identifies CHW ROI of 3:1.