Video Spotlight

"'I'm a Health Worker' - Abduaraman Gidi" made by IntraHealth International.

Peyton Miller, Taylor Bates, and Amy Katzen

Community health workers (CHWs) have shown, time and again, that they can improve health 
outcomes while reducing healthcare costs. Reductions in chronic illness, improved medication 
adherence, more patient involvement, and better community health have been accompanied by a 
return on investment of more than $2 for every dollar invested. Yet several barriers are keeping 
CHWs from being full participants in the healthcare system. According to a 2002 Institute of 
Medicine report, inconsistent scope of practice, training and qualifications; lack of sustainable 
funding; and insufficient recognition by other health professionals are all barriers to the 
integration of CHWs into the broader system.

One approach states have explored to counteract these barriers is to develop some sort of CHW 
credentialing system. The goals of credentialing, as described by Carl Rush in 2012, are to 
achieve greater respect for CHWs among other healthcare professions, improved financial 
compensation and working conditions, increased job stability, and opportunities for more 
sustainable funding. The connection between insurance reimbursement and credentialing or 
standardized training is particularly significant, as both public and private insurance plans are 
likely to require some form of credentialing in order to pay for CHW services. At the same time, 
many CHWs are concerned that credentialing will create barriers to entry for the individuals best 
suited to the job (i.e., members of low-income communities who may not speak English as a first 
language), and/or take CHWs away from their community connections by focusing on 
credentialed ―skills‖ over community relationships.

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Resource Type: 
Center for Health Law and Policy Innovation - Harvard Law School
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