community health workers

Community health workers (CHWs) are trusted laypeople who help their communities achieve health and well-being. For generations, they’ve worked in church basements, shelters, and food pantries to address a variety of health and social needs. In recent years, this workforce has captured the attention of health care organizations looking to hit value-based payment targets that are heavily influenced by the social determinants of health. As a result, they increasingly are transitioning from their grassroots, community-based origins to become integrated members of health care teams. The marriage of community health and formal health care is powerful, but it’s also tricky. If CHWs lose their identity and become medicalized, their effectiveness in the community is lessened. Health care leaders must grapple with a fundamental question: How do we integrate a grassroots workforce into health care without totally coopting it? We explore this tension and offer guidance for health care leaders, based on our experience with developing the IMPaCT CHW model, which has served 10,000 patients in greater Philadelphia and provides tools and technical assistance to more than 1,000 health care organizations across the country. 

The challenges facing CHWs as they become part of health care teams can be thought of as falling into four categories: agenda, identity, scope of work, and integration.