State Policies for Expanding Medicaid Coverage of Community Health Worker (CHW) Services

Community Health Workers (CHWs) are frontline workers who have close relationships with the communities they serve, allowing them to better liaise and connect community members to health care systems. States may authorize Medicaid payment for certain CHW services under state plan or Section 1115 demonstration authority. States may allow or require managed care organizations (MCOs) to provide CHW services or include CHWs in care teams. Many states use CHW services to address the health needs of targeted populations including enrollees with chronic conditions or complex behavioral or physical health needs, enrollees receiving targeted case management services, or frequent users of health care services