Over a decade ago, in a conference room overlooking the lobby of Alivio Medical Center in Chicago, a team of clinicians, diabetes educators, researchers and quality improvement specialists gathered to review the experiences of several patients recently diagnosed with diabetes. One of Alivio’s Compañeros en Salud called the team to order and set the tone for the meeting – one of collaboration to support and assist each patient’s success in meeting their personal goals for managing diabetes in their daily lives. Peers for Progress and the visionary team at Alivio’s Mi Salud Es Primero, My Health Comes First program, served as my introduction to Peer Support and the work of Community Health Workers, and laid the foundation for my professional conviction that health is far more than health care.
For he who has health has hope; and he who has hope, has everything.
— Owen Arthur
It thrills me to celebrate the work of Community Health Workers this week and every day in our efforts to achieve our three strategic aims in pursuit of health, equity, and resilience:
Each of our goals relies on and reinforces the benefits of Community Health Workers, Peer Supporters, Promotores and Compañeros de Salud in advancing the health and well-being of individuals, institutions, and communities.
Value-based contracting offers a path to covering costs for activities that optimize patient engagement and meet whole-person needs independent of reliance on billable activities – a hallmark of fee-for-service arrangements. Well-designed APMs empower patients, primary care teams and their partners to collaboratively design care strategies to achieve improved health outcomes without limiting solutions to those with a defined price and billing code. Additionally, APMs can offer hope for reducing the primary care investment shortfall that impacts family medicine, internal medicine, pediatric, and, in some cases OB/GYN practices preventing them from adequately addressing patients’ unmet physical and psychosocial needs. Prospective payments and two-sided risk arrangements buoy high-performing practices as they expand teams and build infrastructure to allow for increased stability achieved through proven performance improvement, high-quality care delivery and reduced unnecessary healthcare spending.
This stability and reified infrastructure equate to greater stability and resilience in times of crisis and upheaval – periods like that which followed the beginning of the COVID pandemic. Core to this needed infrastructure are systems and resources that keep primary care informed about and connected to the services and supports present and readily available in communities that address health-related social needs. Looking beyond social or community information exchanges, which enable the technical aspects of such connectivity, Community Health Workers serve as the culturally and socially informed conductors of the adaptive side of social support coordination and navigation. As the bridge between clinical, public health, and community services for patients, active, fully funded CHWs in neighborhoods support true whole-person care designed to improve population health and, with time, eradicate structural inequities.
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