Evidence-Based Community Health Worker Program Addresses Unmet Social Needs And Generates Positive Return On Investment

Authors
Shreya Kangovi
Nandita Mitra
David Grande
Judith A. Long
David A. Asch
Journal Article
February 2020

Individualized Management for Patient-Centered Targets (IMPaCT) is an intervention that employs community health workers to provide tailored social support to high-risk patients informed by patient-driven action plans. This economic analysis, based on a high-intensity, six-month IMPaCT intervention among Medicaid-enrolled or uninsured adults with multiple chronic conditions, shows that the program yielded an annual return of $2.47 for every dollar invested by a Medicaid payer by effectively responding to patients’ social determinants of health. IMPaCT also demonstrated improved patient health outcomes and quality of care, as well as reduced hospitalizations, in a related randomized controlled trial. By using data from a randomized trial for an economic analysis, this study provides a more realistic estimate of savings compared to estimates that may be overstated because of regression to the mean.

The authors suggest that the highly structured nature of this community health worker program, including recommended caseloads, supervision ratios, and training, enable the model to be more effective than lighter-touch and less expensive programs to address social needs. While programs to address social needs may target patients with the highest levels of past health care utilization to achieve financial value, this study showed substantial financial value in reaching a broader population. These findings are broadly relevant to policymakers and to health care organizations considering funding community health worker programs to address unmet social needs.  

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Population Addressed
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
Key Questions Answered
  • What is the economic impact of a community health worker program designed to respond to social determinants of health?
  • What are successful attributes for community health worker programs to ensure return on investment?”
Level of Evidence
Strong
What does this mean?