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01-12-2013 | Original Paper

A Cost Analysis of a Community Health Worker Program in Rural Vermont

Authors: Alberta M. Mirambeau, Guijing Wang, Laural Ruggles, Diane O. Dunet

Published in: Journal of Community Health | Issue 6/2013

Abstract

Studies have shown that community health workers (CHWs) can improve the effectiveness of health care systems; however, little has been reported about CHW program costs. We examined the costs of a program staffed by three CHWs associated with a small, rural hospital in Vermont. We used a standardized data collection tool to compile cost information from administrative data and personal interviews. We analyzed personnel and operational costs from October 2010 to September 2011. The estimated total program cost was $420,348, a figure comprised of $281,063 (67 %) for personnel and $139,285 (33 %) for operations. CHW salaries and office space were the major cost components. Our cost analysis approach may be adapted by others to conduct cost analyses of their CHW program. Our cost estimates can help inform future economic studies of CHW programs and resource allocation decisions.

Centers for Disease Control and Prevention. (2011). Rising health care costs are unsustainable. Retrieved from http://www.cdc.gov/workplacehealthpromotion/businesscase/reasons/rising.html.

Fedder, D. O., Chang, R. J., Curry, S., et al. (2003). The effectiveness of a community health worker outreach program on healthcare utilization of west Baltimore City Medicaid patients with diabetes, with or without hypertension. Ethnicity and Disease, 12(1), 22–27.

Johnson, D., Saavedra, P., Sun, E., et al. (2012). Community health workers and Medicaid managed care in New Mexico. Journal of Community Health, 37(3), 563–571.CrossRefPubMed

Felix, H. C., Mays, G. P., Stewart, M. K., et al. (2011). The care span: Medicaid savings resulted when community health workers matched those with needs to home and community care. Health Affairs, 30(7), 1366–1374.CrossRefPubMed

Viswanathan, M., Kraschnewski, J. L., Nishikawa, B., et al. (2010). Outcomes and costs of community health worker interventions: A systematic review. Medical Care, 48(9), 792–808.CrossRefPubMed

Health Resources and Services Administration, Office of Rural Health Policy. (2011). Community health workers evidence-based models toolbox. Washington, DC: US Department of Health and Human Services, HRSA. Retrieved from http://www.hrsa.gov/ruralhealth/pdf/chwtoolkit.pdf.

Wolff, N., Helminiak, T., Morse, G., et al. (1997). Cost-effectiveness evaluation of three approaches to case management for homeless mentally ill clients. American Journal of Psychiatry, 154(3), 341–348.PubMed

Smedley, B., Stith, A., & Nebon, A. (2002). Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: Institute of Medicine.

Primomo, J., Johnston, S., DiBiase, F., et al. (2006). Evaluation of a community-based outreach worker program for children with asthma. Public Health Nursing, 23(3), 234–241.CrossRefPubMed

10.

Elder, J. P., Ayala, G. X., Campbell, N. R., et al. (2005). Interpersonal and print nutrition communication for a Spanish-dominant Latino population: Secretos de la Buena Vida. Health Psychology, 24(1), 49–57.CrossRefPubMed

11.

Patient Protection and Affordable Care Act (2010). Public Law No. 111–148, §2702, 124 Stat. 119, 318–319. Retrieved from http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf.

12.

Paskett, E. D., Harrop, J. P., & Wells, K. J. (2011). Patient navigation: An update on the state of the science. Cancer Journal for Clinicians, 61(4), 237–249.CrossRef

13.

Varner, A., & Murph, P. (2010) Cancer patient navigation: Where do we go from here? Oncology Issues, pp. 50–53. http://accc-cancer.org/oncology_issues/articles/mayjune10/MJ10-VarnerMurph.pdf.

14.

Stockdale, S. E., Keeler, E., Duan, N., et al. (2000). Costs and cost-effectiveness of a church-based intervention to promote mammography screening. Health Services Research, 35(5 Pt 1), 1037–1057.PubMed

15.

Institute of Medicine. (2012). Living well with chronic illness: a call for public health action. Washington, DC: National Academy of Sciences. Retrieved from http://www.iom.edu/~/media/Files/Report%20Files/2012/Living-Well-with-Chronic-Illness/livingwell_chronicillness_reportbrief.pdf.

16.

Harrison, P. L., Pope, J. E., Coberley, C. R., et al. (2012). Evaluation of the relationship between individual well-being and future health care utilization and cost. Population Health Management, 15(6), 325–330.CrossRefPubMed

17.

Saatci, E., Tahmiscioglu, G., Bozdemir, N., et al. (2010). The well-being and treatment satisfaction of diabetic patients in primary care. Health Quality of Life Outcomes, 8, 67.CrossRefPubMed

18.

Allen, J. K., Himmelfarb, C. R., Szanton, S. L., et al. (2011). COACH trial: A randomized controlled trial of nurse practitioner/community health worker cardiovascular disease risk reduction in urban community health centers: Rationale and design. Contemporary Clinical Trials, 32(3), 403–411.CrossRefPubMed

19.

Rural Assistance Center. (2012). Vermont. Retrieved from http://www.raconline.org/states/vermont.php.

20.

US Census Bureau. (2012). Vermont state and county quickfacts. Retrieved from http://quickfacts.census.gov/qfd/states/50000.html.

21.

US Census Bureau. (2012). Caledonia County, Vermont state and county quickfacts. Retrieved from http://quickfacts.census.gov/qfd/states/50/50005.html.

22.

Vermont Department of Health. (2012). Behavioral risk factory surveillance system data map. Retrieved from http://healthvermont.gov/research/IA/HSA/SingleMap/atlas.html.

23.

Centers for Disease Control and Prevention. (2012). Chronic disease indicators. Retrieved from http://apps.nccd.cdc.gov/cdi/SearchResults.aspx?IndicatorIds=0,26,1,33,37,2,15,3,4,6,5,9,35,11,22,64,29,7,8,126,76,73,59,57,45,51,63,70,58,53,47,41,65,69,72,75,48,42,23,18,27,25,13,20,62,56,52,46,40,78,68,28,39,32,12,61,34,31,24,19,38,127,128,129,130,131,132,133,134,36,50,44,136,135,55,16,122,123,124,54,49,10,14,74,77,43,30,17,21,60,&StateIds=46,48&StateNames=United%20States,Vermont&FromPage=HomePage.

24.

Centers for Disease Control and Prevention. (2012). Interactive atlas of heart disease and stroke. Retrieved from http://apps.nccd.cdc.gov/DHDSPAtlas/viewer.aspx?state=VT.

25.

Walker, D. G., & Jan, S. (2005). How do we determine whether community health workers are cost-effective? Some core methodological issues. Journal of Community Health, 30(3), 221–229.CrossRefPubMed

26.

LoopNet Property Records. (2012). Commercial property record: Hospital drive. Retrieved from http://www.loopnet.com/Property-Record/Hospital-Drive-Saint-Johnsbury-VT-05819/TeH0uBy9Q/Sale-Lease/?LID=17002951&LinkCode=21740&PgCxtGuid=bf95f13b-f4d2-4612-9c2b-45596fd033fb&PgCxtFLKey=&PgCxtCurFLKey=Profile&PgCxtDir=Down.

27.

Krieger, J. W., Takaro, T. K., Song, L., et al. (2005). The Seattle-King County Healthy Homes Project: A randomized, controlled trial of a community health worker intervention to decrease exposure to indoor asthma triggers. American Journal of Public Health, 95(4), 652–659.CrossRefPubMed

28.

Whitley, E. M., Everhart, R. M., & Wright, R. A. (2006). Measuring return on investment of outreach by community health workers. Journal of Health Care for the Poor Underserved, 17(1 Suppl), 6–15.PubMed

29.

Balcazar, H., Alvarado, M., Hollen, M. L., et al. (2006). Salud para Su Corazon-NCLR: A comprehensive promotora outreach program to promote heart-healthy behaviors among Hispanics. Health Promotion Practice, 7(1), 68–77.CrossRefPubMed

30.

Brown, H. S., Wilson, K. J., Pagan, J. A., et al. (2012). Cost-effectiveness analysis of a community health worker intervention for low-income Hispanic adults with diabetes. Preventing Chronic Disease, 9, 120074.CrossRef

31.

Brownstein, J. N., Bone, L. R., Dennison, C. R., et al. (2005). Community health workers as interventionists in the prevention and control of heart disease and stroke. American Journal of Preventive Medicine, 29(5S1), 128–133.CrossRefPubMed

32.

Wang, G., Macera, C. A., Scudder-Soucie, B., et al. (2004). Cost analysis of the built environment: The case of bike and pedestrian trials in Lincoln, Neb. American Journal of Public Health, 94, 549–553.CrossRefPubMed

Title: A Cost Analysis of a Community Health Worker Program in Rural Vermont
Authors: Alberta M. Mirambeau
Guijing Wang
Laural Ruggles
Diane O. Dunet
Publication date: 01-12-2013
Publisher: Springer US
Published in: Journal of Community Health / Issue 6/2013
Print ISSN: 0094-5145
Electronic ISSN: 1573-3610
DOI: https://doi.org/10.1007/s10900-013-9713-x

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A Cost Analysis of a Community Health Worker Program in Rural Vermont

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