Community Health Care Worker Model
By Kristen Uppercue
As of 2018 , more than 1 in 10 West Virginia adults were living with diabetes , according to the Division of Health Promotion and Chronic Disease . Additionally , about 13.9 % of West Virginians live with chronic obstructive pulmonary disease ( COPD ), ranking the state highest in the nation , according to the West Virginia Department of Health and Human Resources . If these disorders aren ’ t wellmanaged — as they often aren ’ t in places like West Virginia that face misinformation , lack of education , increasing health care costs and long travel times — it can lead to more emergency room visits and skyrocket health care costs for individuals .
To help West Virginians manage living with health care disorders and fill the gap between access to and quality of primary care , the community health care worker model pairs local health care professionals with patients in need by treating chronic conditions like diabetes , heart failure , COPD and mental health disorders and facing the social determinants of health one is experiencing . Social determinants of health are the environmental conditions that impact one ’ s health , including the availability of community resources , education , public safety , socioeconomic conditions and language .
This health care delivery concept focuses on reducing readmission rates , encouraging disease prevention and , ultimately , reducing overall health care costs . It began 10 years ago as a partnership between the Marshall University School of Public Health and the Williamson Health and Wellness Center in Mingo County . In May 2017 , managed care organizations — including The Health Plan , Marshall University School of Public Health and several federally qualified health centers ( FQHCs )— began enrolling high-risk patients on a continuous basis .
As of January 2020 , more than 700 highrisk patients were enrolled in collaboration with 11 rural FQHCs and rural hospitals in Kentucky , Ohio and West Virginia . The most prevalent chronic condition of those enrolled is diabetes , and nearly 70 % of patients with diabetes that received services from a community health care worker saw their A1c levels lower over a six-month period , according to research compiled by Marshall .
Building trust with the patient is one of the most important facets of the community health care worker model . The health care workers conduct regular home visits to help patients with medication adherence , chronic
disease self-management , healthy eating and active living goals , as well as connecting the patients with community services . These workers serve as client representatives to ensure the patient ’ s needs are articulated and met , reporting directly to a medical provider , coordinating between the patient and a care management team and bridging individuals , families , communities and relevant services . Specifically , they provide culturally appropriate health education , information and outreach in community-based settings , such as one ’ s home , schools , hospitals , clinics , shelters and community centers .
MAKING HEALTH CARE HEALTHY
Medical Billing Authority ( MBA )’ s “ Excellerator ” is a five-tiered medical billing system that is as unique as it is comprehensive of your needs .
• Transparency
• Technology
• Compliance
• Credentialing
• Performance Guarantees
The MBA “ Excellerator ” formula eliminates your risk , implementing a complete performance guarantee package .
medicalbillingauthority . com
WWW . WVEXECUTIVE . COM WINTER 2021 87