Nav: Home

Community health workers lead to better health, lower costs for Medicaid patients

August 17, 2017

PHILADELPHIA -- As politicians struggle to solve the nation's healthcare problems, a new study finds a way to improve health and lower costs among Medicaid and uninsured patients.

Researchers at the Perelman School of Medicine at the University of Pennsylvania showed that patients who received support from community health workers (CHWs) - trained local residents who provide tailored support to high-risk patients- had 30 percent fewer hospital admissions in one year compared to those who did not receive CHW support. The results, published today in the American Journal of Public Health, also showed reductions in cigarette smoking, obesity, diabetes severity, and mental illness. This is the second clinical trial to demonstrate improved health and hospital reductions with the IMPaCT (Individualized Management for Patient-Centered Targets) CHW program. The annual return on investment for the program was $2 for every dollar invested.

The IMPaCT program pairs CHWs with chronically-ill patients from low-income neighborhoods. CHWs meet with patients regularly to encourage healthier behaviors, and otherwise provide support for the patients' own health goals.

Emblematic of the kind of patients who benefit from CHW interventions, one young woman was unemployed, struggling with low self-esteem, and had tried for years to lose weight before she met CHW, Saphia Allen. Saphia helped the patient find affordable interview clothes and went with her to job fairs. Saphia also connected the patient to other neighborhood women and twice a week attended get-togethers with the group where the women would go for walks and share their real-life challenges. With her newfound community, the patient lost 10 pounds and successfully gained employment.

In the new study, the Penn team focused on 302 mostly Medicaid-insured individuals who had multiple chronic diseases. Half received regular support from IMPaCT-trained community health workers. After six months, the patients who had received support from CHWs showed better outcomes on several measures, including lower blood sugar levels, lower body mass index and reduced cigarette smoking. Patients in the intervention group also showed greater improvements in mental health, and were 20 percent more likely to rate their primary care as comprehensive and supportive of their self-management of disease.

"This is the second clinical trial that shows improved health and lower hospital admissions for the IMPaCT community health worker program," says senior author Shreya Kangovi, MD, an assistant professor of Medicine at the Perelman School of Medicine and executive director of the Penn Center for Community Health Workers. In 2014, Kangovi and colleagues found evidence that the IMPaCT model improved mental health and lowered hospital readmission among patients recently discharged from the hospital. "We now have evidence for state Medicaid programs or health systems looking for proven strategies to improve health and lower hospital use."

Based on the reduction in hospitalizations seen in the studies, the University of Pennsylvania Health System estimates a return on investment of $2 for every $1 spent on IMPaCT.

"As a nation, we have spent years arguing about healthcare. We need to focus on getting people healthy while reducing spending," says Ralph Muller, CEO of the University of Pennsylvania Health System. "This program accomplishes both of these goals and shows us a way forward."

Ezekiel Emanuel, MD, PhD, chair of Medical Ethics and Health Policy at Penn, a chief architect of the Affordable Care Act, and an internationally renowned expert on innovative strategies to bend the cost curve, has also pointed to IMPaCT as a role model for nationwide efforts to transform health care. Kangovi and colleagues have adapted IMPaCT for a variety of other settings and developed web-based tools that have been accessed by approximately one thousand organizations around the United States.
-end-
Other Penn co-authors on the study were Nandita Mitra, David Grande, Hairong Huo, Robyn A. Smith and Judith A. Long.

Funding for the study was provided by Penn Medicine's Agency for Healthcare Research & Quality, Penn's Institute for Translational Medicine and Therapeutics, and the National Heart, Lung and Blood Institute (K23 HL128837).

Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $6.7 billion enterprise.

The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $392 million awarded in the 2016 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center -- which are recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report -- Chester County Hospital; Lancaster General Health; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2016, Penn Medicine provided $393 million to benefit our community.

University of Pennsylvania School of Medicine

Related Obesity Articles:

Changing the debate around obesity
The UK's National Health Service (NHS) needs to do more to address the ingrained stigma and discrimination faced by people with obesity, says a leading health psychologist.
Study links longer exposure to obesity and earlier development of obesity to increased risk of type 2 diabetes
Cumulative exposure to obesity could be at least as important as actually being obese in terms of risk of developing type 2 diabetes (T2D), concludes new research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]).
How much do obesity and addictions overlap?
A large analysis of personality studies has found that people with obesity behave somewhat like people with addictions to alcohol or drugs.
Should obesity be recognized as a disease?
With obesity now affecting almost a third (29%) of the population in England, and expected to rise to 35% by 2030, should we now recognize it as a disease?
Is obesity associated with risk of pediatric MS?
A single-center study of 453 children in Germany with multiple sclerosis (MS) investigated the association of obesity with pediatric MS risk and with the response of first-line therapy in children with MS.
Women with obesity prior to conception are more likely to have children with obesity
A systematic review and meta-analysis identified significantly increased odds of child obesity when mothers have obesity before conception, according to a study published June 11, 2019 in the open-access journal PLOS Medicine by Nicola Heslehurst of Newcastle University in the UK, and colleagues.
Obesity medicine association announces major updates to its adult obesity algorithm
The Obesity Medicine Association (OMA) announced the immediate availability of the 2019 OMA Adult Obesity Algorithm, with new information for clinicians including the relationship between Obesity and Cardiovascular Disease, Diabetes Mellitus, Dyslipidemia, and Cancer; information on investigational Anti-Obesity Pharmacotherapy; treatments for Lipodystrophy; and Pharmacokinetics and Obesity.
Systematic review shows risk of a child developing overweight or obesity is more than trebled by maternal obesity prior to pregnancy
New research presented at this year's European Congress on Obesity (ECO) in Glasgow, Scotland (April 28- May 1) reveals that the risk of a child becoming overweight or obese is more than trebled by maternal obesity prior to getting pregnant.
Eating later in the day may be associated with obesity
Eating later in the day may contribute to weight gain, according to a new study to be presented Saturday at ENDO 2019, the Endocrine Society's annual meeting in New Orleans, La.
How obesity affects vitamin D metabolism
A new Journal of Bone and Mineral Research study confirms that vitamin D supplementation is less effective in the presence of obesity, and it uncovers a biological mechanism to explain this observation.
More Obesity News and Obesity Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Teaching For Better Humans 2.0
More than test scores or good grades–what do kids need for the future? This hour, TED speakers explore how to help children grow into better humans, both during and after this time of crisis. Guests include educators Richard Culatta and Liz Kleinrock, psychologist Thomas Curran, and writer Jacqueline Woodson.
Now Playing: Science for the People

#556 The Power of Friendship
It's 2020 and times are tough. Maybe some of us are learning about social distancing the hard way. Maybe we just are all a little anxious. No matter what, we could probably use a friend. But what is a friend, exactly? And why do we need them so much? This week host Bethany Brookshire speaks with Lydia Denworth, author of the new book "Friendship: The Evolution, Biology, and Extraordinary Power of Life's Fundamental Bond". This episode is hosted by Bethany Brookshire, science writer from Science News.
Now Playing: Radiolab

Dispatch 3: Shared Immunity
More than a million people have caught Covid-19, and tens of thousands have died. But thousands more have survived and recovered. A week or so ago (aka, what feels like ten years in corona time) producer Molly Webster learned that many of those survivors possess a kind of superpower: antibodies trained to fight the virus. Not only that, they might be able to pass this power on to the people who are sick with corona, and still in the fight. Today we have the story of an experimental treatment that's popping up all over the country: convalescent plasma transfusion, a century-old procedure that some say may become one of our best weapons against this devastating, new disease.   If you have recovered from Covid-19 and want to donate plasma, national and local donation registries are gearing up to collect blood.  To sign up with the American Red Cross, a national organization that works in local communities, head here.  To find out more about the The National COVID-19 Convalescent Plasma Project, which we spoke about in our episode, including information on clinical trials or plasma donation projects in your community, go here.  And if you are in the greater New York City area, and want to donate convalescent plasma, head over to the New York Blood Center to sign up. Or, register with specific NYC hospitals here.   If you are sick with Covid-19, and are interested in participating in a clinical trial, or are looking for a plasma donor match, check in with your local hospital, university, or blood center for more; you can also find more information on trials at The National COVID-19 Convalescent Plasma Project. And lastly, Tatiana Prowell's tweet that tipped us off is here. This episode was reported by Molly Webster and produced by Pat Walters. Special thanks to Drs. Evan Bloch and Tim Byun, as well as the Albert Einstein College of Medicine.  Support Radiolab today at Radiolab.org/donate.