Enhancing the Engagement of Community Health Workers in Diabetes Care: Lessons Learned from U.S. States and Cities this book uncovers interesting issues of the moment by in the year 2017 referenced for you if you want book quote . this book uncovers interesting issues of the moment composed by Saunders Magon, with count of page Pages. you can see book review at the bottom
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Community health workers (CHWs) are on the frontline and facilitate connections between their ethnic, cultural, or geographic communities and health care providers. As such, they play a critical role in connecting communities to health systems, particularly in minority, rural, and other underserved communities. CHWs reduce health care costs by decreasing unnecessary or avoidable emergency department utilization or hospital services, increasing preventive health screening for early detection, and delivering health education. In 2014, the Centers for Medicare & Medicaid Services (CMS) recognized the importance of CHWs in healthcare teams, and approved a payment rule to allow state Medicaid agencies to reimburse for preventive services provided by professionals (including CHWs) that may fall outside of a stateu2019s clinical licensure system, as long as the services have been initially recommended by a physician or other licensed practitioner. Despite this rule, this option has only been utilized by three statesu2014Minnesota, Texas, and New Mexico. Minnesota used a state plan approach, and Texas and New Mexico used 1115 waivers to reimburse CHWs for their services. In 2017, the U.S. Community Preventive Services Task Force (USPSTF) recommended engaging CHWs for diabetes prevention interventions based on sufficient evidence of effectiveness in improving glycemic control and weight-related outcomes among people at increased risk for type 2 diabetes. Additionally, the USPSTF noted that interventions that engage CHWs in a team-based care model intended to improve blood pressure and cholesterol are effective in improving health, reducing health disparities, and enhancing health equity.AimSince 2013, the U.S. Centers for Disease Control and Prevention (CDC) funded all state health departments under a funding opportunity announcement (FOA-1305), to increase the use of health-care extenders, such as CHWs, in the community to support self-management of high blood pressure (HBP) and type 2 diabetes. In addition, under a complementary FOA (1422), 21 state and large city grantees were charged with increasing the engagement of non-physician team members, such as CHWs, to promote linkages between health systems and community resources for adults with high blood pressure and prediabetes.MethodIn 2017, data analysis of the annual performance reports (APRs) of funded states and cities was completed, and the results used to develop this abstract.ResultsIn 2017, 1305 grantees were working to increase the use of CHWs to improve management of diabetes and high blood pressure. Key areas of focus included: u2022tProviding training, apprenticeships, and recognition for CHWs; u2022tImplementing policy and system changes to allow CHWs to be embedded in teams. u2022tOffering health education and health promotion activities to expand program reach.u2022tIncreasing sustainability and reimbursement for CHWs using waivers or other private grant funds.Data analysis from the APRs of all 1422 grantees showed that grantees were working in the following areas:u2022tOffering training for CHWs, health care providers (HCPs), and others. u2022tDeveloping toolkits and other resources on CHWs for patients and HCPs.u2022tDeveloping marketing materials to increase awareness of the value of CHWs.u2022tInitiating assessments of curricula, reimbursement mechanisms, and the use of CHWs in states and cities.u2022tImplementing clinical CHW practice models, academic detailing for HCPs, medication assessments, and e-referral processes;u2022tDeveloping reports and white papers on CHWs, highlighting lessons learned and best practices in states, and describing health education outcomes associated with clients with prediabetes and hypertension who have received services from CHWs; andu2022tDeveloping and delineating roles for CHWs, associated training curricula, and reimbursement policies.All grantees reported several barriers to this work, including an unclear understanding of public healthu2019s role in the work with CHWs, the lack of reimbursement for CHWs, inability to sustain this work with inconsistent funding, and a lack of standardized training and certification programs. DiscussionBased on qualitative reporting from grantees it seem that a lack of uniform national CHW standards, training curricula, certification programs, consistent funding, and sustainable mechanisms for reimbursement have resulted in sub-optimal use of CHWs in the U.S. However, CDCu2019s efforts to increase the use of CHWs in diabetes prevention and management has begun to lay the foundation for scalable models that could form the framework for a national system to enhance the use of CHWs in chronic disease self-management.
Enhancing the Engagement of Community Health Workers in Diabetes Care: Lessons Learned from U.S. States and Cities
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