Sustainable Financing Models for Community Health Worker Services in Maine

UMass Medical School health policy experts have developed sustainable financing models for the state of Maine to support four community health worker (CHW) interventions that focus on patients with the greatest, and most costly, health care needs. The report examines academic literature documenting results obtained by CHW interventions in other parts of the country, calculates the outcomes that could be achieved if the same interventions were implemented in Maine, and provides budget specifications needed to achieve those outcomes Using actual population and cost data from Maine, interviews with Maine CHWs and features of CHW interventions operating in other states, the team constructed four cost-effective models that target specific health concerns in different Maine counties. These models can be used by community-based organizations, health care providers, public and private payers, and others to develop sustainable CHW interventions throughout the state of Maine

Demonstrating Return on Investment for Community Health Worker Services: Translating Science into Practice

Learn about interventions that employ community health workers to improve health outcomes for select patient groups while containing costs. UMass staff constructed models to focus on specific health issues, such as diabetes and asthma, in particular regions in Maine. The models are designed to promote widespread adoption of payment models and mechanisms that support CHWs’ work

A new resource to understand how countries have responded to COVID-19

Some countries have been better positioned to limit the spread of COVID-19 than others. Roosa Tikkanen, Ana Djordjevic, Reginald D Williams II (Commonwealth Fund) and George A Wharton and Elias Mossialos (LSE) introduce the 2020 International Profiles of Health Care Systems, which help to understand how 20 countries, including Germany, Norway and Taiwan, have made decisions about health care

Mirror, Mirror 2021: Reflecting Poorly - Health Care in the U.S. Compared to Other High-Income Countries

Issue: No two countries are alike when it comes to organizing and delivering health care for their people, creating an opportunity to learn about alternative approaches.Goal: To compare the performance of health care systems of 11 high-income countries.Methods: Analysis of 71 performance measures across five domains — access to care, care process, administrative efficiency, equity, and health care outcomes — drawn from Commonwealth Fund international surveys conducted in each country and administrative data from the Organisation for Economic Co-operation and Development and the World Health Organization.Key Findings: The top-performing countries overall are Norway, the Netherlands, and Australia. The United States ranks last overall, despite spending far more of its gross domestic product on health care. The U.S. ranks last on access to care, administrative efficiency, equity, and health care outcomes, but second on measures of care process.Conclusion: Four features distinguish top performing countries from the United States: 1) they provide for universal coverage and remove cost barriers; 2) they invest in primary care systems to ensure that high-value services are equitably available in all communities to all people; 3) they reduce administrative burdens that divert time, efforts, and spending from health improvement efforts; and 4) they invest in social services, especially for children and working-age adults

Sosiaalinen tuki ryhmämuotoisessa päihdeavokuntoutuksessa: kyselylomakkeen tuotteistaminen sosiaalisen tuen kokemusten keräämiseksi ryhmämuotoisen päihdeavokuntoutuksen asiakkailta

Opinnäytetyömme yhteistyökumppanina toimi avopäihdepalveluja tuottava organisaatio. Heidän toiveenaan opinnäytetyöllemme oli, että laatisimme tuotteen, jota he voisivat hyödyntää ryhmämuotoisen päihdeavokuntoutuksen kehittämisessä. Toteutimme opinnäytetyömme toiminnallisena. Tavoitteenamme oli luoda yhteistyökumppanimme käyttöön sähköinen kyselylomake asiakkaiden kokemustiedon keräämiseksi ryhmämuotoisesta päihdeavokuntoutuksesta. Kyselylomaketta hyödyntämällä yhteistyökumppanimme voi kehittää toimintaansa vastaamaan paremmin asiakkaiden tarpeisiin. Sosiaalialan opiskelijoina aiheen rajaustamme ohjasi oman ammattialamme viitekehys ja rajasimme aiheemme sosiaaliseen tukeen. Rajasimme kyselylomakkeemme aihetta vielä tarkemmin ryhmämuotoisesta päihdeavokuntoutuksesta saatuun sosiaaliseen tukeen sekä niihin tuen muotoihin, jotka vastaavat toiminnan luonnetta. Aihe on ajankohtainen, sillä avohoidon käyntimäärät ovat lisääntyneet viime vuosina. Avopäihdepalveluista ei ole tehty sosiaalisen tuen näkökulmasta opinnäytetöitä eikä suomalaisia tutkimuksia. Teoriapohjamme sisältää pääkäsitteemme sosiaalisen tuen lisäksi teoreettista tietoa päihteistä ja riippuvuudesta sekä siitä toipumisesta. Käsittelemme sosiaalisen tuen sekä kuntoutuksen merkitystä osana toipumista. Käytimme lähteinä sekä suomalaista että ulkomaalaista kirjallisuutta. Tarkastelimme sosiaalisen tuen teoriaosuudessa keskeisesti sen muotoja, tasoja sekä sen vastaanottamiseen vaikuttavia tekijöitä. Opinnäytetyömme kyselylomakkeen laadimme Jämsä & Mannisen (2000) viisivaiheisen tuotekehitysprosessimallinnuksen mukaisesti. Näitä vaiheita ovat kehittämistarpeiden tunnistaminen, ideavaihe, luonnosteluvaihe, kehittelyvaihe sekä viimeistelyvaihe. Teimme tiivistä yhteistyötä yhteistyökumppanimme kanssa koko prosessin ajan ja hyödynsimme heidän asiantuntijuuttaan toiminnasta. Keräsimme yhteistyökumppaniltamme palautetta ja kehitimme kyselylomaketta saadun palautteen perusteella. Yhteistyökumppanimme myös testasivat kyselylomaketta viimeistelyvaiheessa muutamalla asiakkaalla, joilta saimme arvokasta palautetta kehittämisen tueksi. Lähetimme valmiin kyselyn sekä kyselylomakkeelle asettamiemme laatutavoitteiden pohjalta laaditun palautelomakkeen yhteistyökumppanillemme. He olivat tyytyväisiä kyselyyn ja kokivat sen vastaavan tarvetta. Palautteen perusteella onnistuimme myös täyttämään kyselylle asettamamme laatutavoitteet.This thesis was done for an organization that offers a variety of different services for substance abuse care. The organization wished for a product that could help them gather customer feedback to enable the development of their group-based outpatient rehabilitation for substance abuse, and to better answer the needs of the customers. The thesis was executed in a practice-based format. The goal of this thesis was to create said product, an electric customer feedback questionnaire template, for the organization. The theory base of this thesis focuses on the main aspects of social support and its impacts on rehabilitation. The theory base also gives details of intoxicants, addiction, and recovery from addiction. The theory basis was formed on mainly Finnish literature, due to the nature of the topic. The actual product development process of the questionnaire template was based on the findings from the literature. The main steps that were followed were to identify the targets of improvement, idea creation, draft phase, creation phase and finalization of the complete product. The target organization was tightly involved throughout the process. The expertise they provided on the subject matter and the continuous feedback further improved the quality of the final questionnaire template. A trial run was also executed for the template, by the target organization, in the finalization stage of the product development process. The finalized questionnaire template was then given to the target organization for valuation, and the feedback received was positive. They saw that the template answered their needs. According to the received feedback, the final template met the quality standards that were set for it in sub-chapter 5.2

Sustainable Financing Models for Community Health Worker Services in Connecticut: Translating Science into Practice

Researchers at UMass Medical School developed four community health worker (CHW) models aligned with priorities of Connecticut’s State Innovation Model (SIM), a federally funded grant initiative to transform state health care systems. The models target high-need, high-cost patients – the populations for which CHW interventions are most likely to improve health outcomes and generate cost savings. The analysis applies results obtained by successful interventions in other parts of the country and projects outcomes that could be achieved if the same interventions were implemented in Connecticut. Evidence compiled from research studies, interviews with Connecticut CHW employers, and state public health data were used to construct cost-effective CHW models. Specific state population and cost data were used to create the most cost-effective model for each community

Community Health Workers: A Positive Return on Investment for Connecticut

Research demonstrates that community health workers enhance patient experience, strengthen care coordination, improve clinical outcomes, and can help to control health care costs. To demonstrate the impact community health workers’ could have in Connecticut and the strong return on investment they offer, the Connecticut Health Foundation commissioned our Center for Health Law and Economics to design four potential interventions based on successful models in other states. This brief offers details on the researchers findings and what community health workers can do to benefit healthcare in Connecticut

An anthropological history of Nepal’s Female Community Health Volunteer program: gender, policy, and social change

Abstract Background Community health workers (CHWs) are central to Primary Health Care globally. Amidst the current flourishing of work on CHWs, there often is a lack of reference to history—even in studies of programs that have been around for decades. This study examines the 35-year trajectory of Nepal’s Female Community Health Volunteers (FCHVs). Methods We conducted a content analysis of an archive of primary and secondary research materials, grey literature and government reports collected during 1977-2019 across several regions in Nepal. Documents were coded in MAXQDA using principles of inductive coding. As questions arose from the materials, data were triangulated with published sources. Results Looking across four decades of the program’s history illuminates that issues of gender, workload, and pay—hotly debated in the CHW literature now—have been topics of discussion for observers and FCHVs alike since the inception of the program. Following experiments with predominantly male community volunteers during the 1970s, Nepal scaled up the all-female FCHV program in the late 1980s and early 1990s, in part because of programmatic goals focused on maternal and child health. FCHVs gained legitimacy as health workers in part through participation in donor-funded vertical campaigns. FCHVs received a stable yet modest regular stipend during the early years, but since it was stopped in the 1990s, incentives have been a mix of activity-based payments and in-kind support. With increasing outmigration of men from villages and growing work responsibilities for women, the opportunity cost of health volunteering increased. FCHVs started voicing their dissatisfaction with remuneration, which gave rise to labor movements starting in the 2010s. Government officials have not comprehensively responded to demands by FCHVs for decent work, instead questioning the relevance of FCHVs in a modern, medicalized Nepali health system. Conclusions Across public health, an awareness of history is useful in understanding the present and avoiding past mistakes. These histories are often not well-archived, and risk getting lost. Lessons from the history of Nepal’s FCHV program have much to offer present-day debates around CHW policies, particularly around gender, workload and payment

Additional file 1 of An anthropological history of Nepal’s Female Community Health Volunteer program: gender, policy, and social change

Supplementary Material