Center for Health Care Strategies

As frontline public health workers who are predominantly people of color, Community Health Workers (CHWs) serve as a critical bridge between patients from marginalized communities and the health care system. Recent policy changes have increased opportunities for CHW integration. Medicare now reimburses CHW services for older adults with health-related social needs nationwide, and New York State has joined 23 other states in initiating Medicaid reimbursement for CHW services for pregnant and postpartum women, children, adults with health-related social needs, and other high-risk populations. However, this potential remains largely untapped. In 2024, NYHealth awarded the Center for Health Care Strategies (CHCS) a grant to equip providers and policymakers with the tools to integrate CHWs into primary care and maximize Medicare and Medicaid reimbursements. 

Under this grant, CHCS will launch and facilitate a learning collaborative with six clinical and community-based providers seeking to bill Medicare and Medicaid for CHW services. Participating organizations will identify barriers to reimbursement and design solutions to overcome them. CHCS will provide tailored technical assistance, host educational workshops, and support shared learning. It will develop and widely disseminate a toolkit to help New York providers navigate and braid Medicare and Medicaid reimbursement. Finally, it will make policy recommendations to improve Medicare and Medicaid CHW benefits or better coordinate their implementation.