Community Health Workers — A Local Solution to a Global Problem

Abstract

In the face of persistently lackluster job creation, the U.S. health sector is paradoxically seen as both a contributor to torpid macroeconomic growth and a source of local employment opportunities. Labor costs account for more than half of U.S. health care spending, but as payment structures shift from volume-based reimbursement to the rewarding of value in improving health, the locus of health care delivery will expand from facilities to communities. Ideally, patient care will take place not just in episodic encounters but also through continuous, community-based partnerships that include new entities and workers. Elsewhere in the world, such care has involved the use of community health workers (CHWs) — lay community members with focused health care training. We believe that scaling up the community health workforce in the United States could improve health outcomes, reduce health care costs, and create jobs.