Supporting Pennsylvania’s Community Health Workers

May 28, 2024

Community health workers (CHW) play a critical role to support access, outcomes, and health equity across Pennsylvania.

This month, HAP and over 100 statewide partners signed on to a letter urging support of a state plan amendment that would authorize Medical Assistance (MA) payment for community health worker services.

“Pennsylvania faces critical challenges: clinical workforce shortages, ongoing concerns about health equity and the need to deliver better outcomes at lower costs,” the letter from the Pennsylvania Community Health Worker Collaborative said. “The commonwealth’s community health workers are well-poised to address these needs, improving access, outcomes, and health equity while reducing MA costs.”

Here’s what you need to know:

• Background:  Since 2023, Pennsylvania leaders have been developing a state plan amendment that would reimburse community health worker services through Medicaid.
  • The letter calls for Pennsylvania to eliminate barriers for community-based organizations and other CHW employers to participate in Medicaid billing for these services.
• About:  Community health workers leverage their own community experiences to help patients in their region, providing “tailored social support, advocacy, navigation, and coaching to help them improve their health and well-being.”
• Call to action:  The letter urges “swift action” to ensure timely implementation of the state plan amendment as federal COVID-19-related funds for community health workers expire this year.
• Recommendations:  The letter includes a series of recommendations related to reimbursement, coding, and other barriers that impact access to community health workers in rural communities.
• Quotable:  “CHWs remove barriers, such as transportation, food insecurity, and housing, that prevent Pennsylvanians from accessing medical care in the first place,” the letter notes.

The letters to Governor Shapiro and leaders from the Department of Human Services are available online.