Impact on Health Care Utilization and Costs of a Medicaid Community Health Worker Program in Detroit, 2018

Authors: Michele Heisler, Adrienne Lapidos, Edith Kieffer, James Henderson, Rebeca Guzman, Jasmina Cunmulaj, Jason Wolfe, Trish Meyer, John Z Ayanian

In this article, researchers compare health care utilization and costs between patients who received usual care services and patients who received care from community health workers in Detroit, Michigan, United States. Medicaid beneficiaries with more than 3 emergency room visits or 1 or more ambulatory care hospitalizations in the past 12 months were randomized to a control or treatment arm. Participants in the treatment arm were contacted by a CHW who conducted a needs assessment, developed an action plan, and connected patients with the appropriate services. Those in the control arm received usual care. Following a 12-month intervention period, researchers found that participants in the treatment group were less likely to visit an emergency department but had greater average ambulatory care costs. Additionally, authors found no significant differences in inpatient and total health costs between the two groups. Authors concluded that while CHW programs may in the short term increase use of ambulatory care sufficiently to match cost savings from decreased acute care utilization, additional follow-up data are necessary to assess longer-term patterns of health care use and potential cost savings from improved health.