In November 2011 the Centers for Medicare and Medicaid
Services (CMS) announced the Health Care Innovation Challenge program that
would award up to $1 billion in grants for efforts to improve care and lower
costs for patients with public coverage. On May 1st, The Office of Health and
Human Services announced the first 26 recipients of these grants totaling
$122.6 million. Many of these projects are of particular interest to those
working with community health workers and in the field of peer support. This
blog takes a brief look at some of the innovative ways recipients have proposed
incorporating peer support in their grants:
The Center for Health Care Services in San Antonio Texas was
awarded $4,557,969 for work with homeless adults in San Antonio with severe
mental illness or co-occurring mental illness and substance abuse disorders, at
risk for chronic physical diseases. Their intervention will integrate health
care into behavioral health clinics. A multi-disciplinary care team will
coordinate behavioral, primary, and tertiary health care for patients that are
primarily Medicaid beneficiaries or eligible for Medicaid to improve their
capacity to self-manage, reducing emergency room admissions, hospital
admissions, and lowering costs, while improving health and quality of life and
with estimated savings of $5 million over 3 years. The program will train
workers to provide peer support to
generate readiness for change, build motivation, and sustain compliance.
The Courage center in Minnesota received $1,767,667 to test
a community-based medical home model to serve adults with disabilities and other
complex health conditions. The intervention will coordinate and improve access
to primary and specialty care, increase adherence to care, and empower
participants to better manage their own health. Over 50 Independent Living
Skills Specialists, Peer Leaders,
and other health professionals will be trained with enhanced skills to fulfill the
medical home mission. This community-based and patient-centered approach is
expected to reduce avoidable hospitalizations, lower cost, and improve the
quality of care for this vulnerable group of people with an estimated savings
of over $2 million over the three year award.
Duke University, in conjunction with the University of
Michigan National Center for Geospatial Medicine, Durham County Health
Department , Cabarrus Health Alliance (Cabarrus County, NC), Mississippi Public
Health Institute, Marshall University, and Mingo County Diabetes Coalition
(Mingo County, WV) received $9,773,499 for its plan to reduce death and
disability from Type 2 diabetes mellitus among fifty-seven thousand people in
four Southeastern counties who are underserved and at-risk populations in the
Southeast. The program will use informatics systems that stratify patients and
neighborhoods by risk, target communities in need of higher-intensity
interventions, and serve as the basis for decision support and real-time
monitoring of interventions. Local home care teams will provide
patient-centered coordinated care to improve outcomes and lower cost —
expecting to reduce hospital and emergency room admissions and reduce through
preventive care the need for amputations, dialysis, and cardiac procedures with
estimated savings of over $20 million. Over the three-year period, this
collaborative program will train an estimated 88 health care workers and create
an estimated 31 new jobs. These workers include new types of health workers including
information officers, health integrators, and community health workers, who will use novel technologies to
facilitate communication, education, and care delivery.
Joslin Diabetes Center, Inc. received $4,967,276 to expand
their “On the Road” program that will send trained community health workers
into community settings to help approximately 3000 Medicare and Medicaid
beneficiaries and low income/uninsured populations understand their risks and
improve health habits for the prevention and management of diabetes. The
program will target at risk and underserved populations in New Mexico,
Pennsylvania, and Washington, D.C., helping to prevent the development and
progression of diabetes and reducing overall costs, avoidable hospitalizations,
and the development of chronic co-morbidities.
After our previous blog discussing community health workers
in the US workforce and efforts to demonstrate their value to the healthcare
system, this round of funding demonstrates the government’s interest in
increasing the role of community health workers and peers supporters in the
health system. To read about the other award winners please check out http://innovations.cms.gov/initiatives/Innovation-Awards/Project-Profiles.html.
The next round of recipients will be announced in June and we will look forward
to seeing additional ways for peer supporters and community health workers to
be incorporated into improving health across the nation.
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