{"title":"Billing Medicaid for Community Health Worker Services: The Promise, Pitfalls, and Path Forward.","authors":"Mechelle R Sanders, Kevin Fiscella","doi":"10.3122/jabfm.2025.250301R1","DOIUrl":null,"url":null,"abstract":"<p><p>This commentary examines the implications of the Community Health Worker (CHW) Access Act introduced by Congress. If passed, primary care practices would be able to receive reimbursement for CHW services. CHWs are lay members of the community that help people address the social determinants of health, understand their health, and get the health care they need, especially in communities where resources are scarce. They have been shown to improve health outcomes, yet many serve in unpaid positions and their services have not been readily reimbursable in the healthcare system. We highlight the potential of the Bill to facilitate the uptake of CHWs in primary care. This is particularly important at a time when the provision of primary care is scarce. We examine the potential and pitfalls of the Bill and recommend implementation strategies to support the uptake of CHWs into primary care. This commentary aims to inform stakeholders about the Bill's broader impact on primary care and future CHW sustainability.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Board of Family Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3122/jabfm.2025.250301R1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
This commentary examines the implications of the Community Health Worker (CHW) Access Act introduced by Congress. If passed, primary care practices would be able to receive reimbursement for CHW services. CHWs are lay members of the community that help people address the social determinants of health, understand their health, and get the health care they need, especially in communities where resources are scarce. They have been shown to improve health outcomes, yet many serve in unpaid positions and their services have not been readily reimbursable in the healthcare system. We highlight the potential of the Bill to facilitate the uptake of CHWs in primary care. This is particularly important at a time when the provision of primary care is scarce. We examine the potential and pitfalls of the Bill and recommend implementation strategies to support the uptake of CHWs into primary care. This commentary aims to inform stakeholders about the Bill's broader impact on primary care and future CHW sustainability.
期刊介绍:
Published since 1988, the Journal of the American Board of Family Medicine ( JABFM ) is the official peer-reviewed journal of the American Board of Family Medicine (ABFM). Believing that the public and scientific communities are best served by open access to information, JABFM makes its articles available free of charge and without registration at www.jabfm.org. JABFM is indexed by Medline, Index Medicus, and other services.