While community health worker (CHW) programs that serve low-income populations have demonstrated reductions in preventable acute care utilization, these programs often have limited funding. Developing a sustainable funding strategy will be critical for expansion of CHW programs, which are primarily funded by grants, managed care plans, health care systems, or government agencies.
This study estimates the break-even point at which a CHW program to address medical and social needs will offset program costs through reducing emergency department visits and hospitalizations. The authors found that an annual caseload of 150 participants per CHW would yield a sufficient reduction in emergency department visits to achieve cost neutrality. Program information and break-even estimates for low-cost, mid-cost, and high-cost regions across the United States are provided in this analysis, which can serve as a reference point for decision-makers considering CHW programs that address health and social needs.
- Can a community health worker program achieve sufficient reductions in utilization to offset program costs?