Community health worker (CHW) programs have historically been funded through contracts or as pilot programs, and many CHW programs are experiencing funding gaps as COVID-19-related funds end and broader federal policy priorities shift. New payment mechanisms in Medicaid and Medicare create opportunities to sustain this workforce and expand access to CHW services. In New York State, financing pathways for CHW services include the Medicaid CHW Benefit, Social Care Network Contracts, and Medicare Community Health Integration (CHI) Services. While these reimbursement pathways create opportunities for providers and CBOs to expand access to CHW services, uptake has been challenging for many organizations due to barriers such as infrastructure requirements, coding and documentation challenges, and issues with integrating CHWs into cross-sector teams.

In response, the Center for Health Care Strategies (CHCS) is launching the New York Community Health Worker Reimbursement and Sustainability Learning Collaborative with support from the New York Health Foundation. This 12-month initiative will assist up to six competitively selected New York-based organizations that are currently providing CHW services, including health systems and hospitals; community-based organizations; federally qualified health centers or other health centers/clinics; and Social Care Network lead entities. The learning collaborative will strengthen the knowledge and capacity of participants to access and braid Medicaid and/or Medicare funding to sustain and expand CHW service delivery.

Participants will participate in virtual learning sessions and receive individualized technical assistance from CHCS staff. Topics addressed through the learning collaborative will be identified based on participants’ needs and interests. Representatives from the New York State Department of Health will also participate during a portion of each learning session to foster discussion on questions and issues related to Medicaid financing of CHW services.