Success with CHWs: Mental Health Services

Lower costs

TwoHmongMenMany 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 CHW cost-effectiveness and ROI.

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%. 

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body of published research on the effectiveness of CHWs, but that much of the evidence of CHW costs savings is still unpublished.  He emphasizes in his 2012 article in the Journal of Ambulatory Care Management that ROI analysis for CHWs must consider a range of CHW roles and stakeholder points of view. 

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.

CHWs — helping mental health service providers respond to changing times

Eva Sebesta

Eva Sebesta

"It’s not uncommon for individuals with a mental health diagnosis to frequently visit emergency rooms instead of going to a general practitioner or some other type of healthcare provider. In one such situation, I worked with the individual’s medical provider to set up more frequent visits. Initially, the visits were once a week, then every other week, then once a month.

What we found was that as they were visiting that medical provider with more frequency, those healthcare concerns were being addressed more quickly. It really helped the individual to take a little bit more control of their wellness so they weren’t using the emergency room in place of a regular doctor visit.

They were monitoring their health and wellness more closely and addressing health issues that were coming up instead of letting them become a huge challenge for them."

— Eva Sebesta, CHW and Program Director, Northern Lights Clubhouse, Ely, Minnesota