Where is the Break-even Point for Community Health Workers? Using National Data and Local Programmatic Costs to Find the Break-even Point for a Metropolitan Community Health Worker Program

Authors
Tami Gurley-Calvez
Jessica A.R. Williams
Peer-Reviewed Article
April 2020

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.

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Key Questions Answered
  • Can a community health worker program achieve sufficient reductions in utilization to offset program costs?
Level of Evidence
Moderate
What does this mean?