Referring them to a Community Health Worker Might Just be the Ticket
Community Health Workers are frontline public health workers who have a trusted relationship with the community and help access to a variety of services and resources for community members.
CHWs facilitate access to services and improve the quality and cultural competence of service delivery, including the coordination of services to improve medical and behavioral health outcomes.
Building CHWs into the continuum of care has been proven to both improve health outcomes and reduce healthcare costs… especially when it comes to preventing and self-managing chronic diseases.
Arizona has been working hard over the last several years to build the infrastructure to use the skills of Community Health Workers at scale within Arizona’s healthcare network.
We finally made it!
This week AHCCCS announced that they will begin registering CHWs as AHCCCS providers setting the stage for Medicaid reimbursement starting April 1, 2024.
Claims for covered services provided by the certified Community Health Worker need to be sent by a registered AHCCCS provider. CHWs can be employed by multiple AHCCCS registered providers.
The Community Health Worker needs to be certified by ADHS and can only deliver covered services within their scope of practice under specified AHCCCS registered provider types (provider types are listed in Question 8 of the CHW/CHR Frequently Asked Questions).
Additional billing guidance is available in this AHCCCS Provider Billing Manual. You might also check with your contracted Medicaid health plans for a list of in network CHWs available for clinician referral.
Kudos to the network of industrious and tenacious folks who have been working toward this goal over the last several years!
Let’s start referring patients!
Note: For a picture of how CHWs can fit into a continuum of care, take a look at this report from the NAU Center for Health Equity Research in collaboration with the UA Prevention Research Center which provides insight into innovative strategies for integrating, sustaining and scaling of the CHW workforce within Medicaid.
