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Road Warriors: The Community Health Worker’s Vital Role in Rural Health Care Delivery – Highlights from AHIP Webinar


Emcara Health Editors


October 23, 2023


Ultimately, more than 50 million Americans live in areas that are experiencing a significant shortage of access to primary care and specialty services. Additionally, obstacles like transportation, health literacy, language barriers and privacy concerns can make accessing healthcare even more challenging.

Because of this, the demand for Community Health Workers (CHWs) is increasing as health plans and provider organizations realize their potential to connect underserved and under-resourced individuals to much-needed, often inaccessible, care. Specifically, when supporting rural populations, CHWs play a critical role as a point of entry and a core part of a care team who supports these members in the places they call home.

During a recent AHIP webinar, a panel of experts clearly defined the responsibilities and capabilities of CHWs as well as how to better integrate them into care teams to effectively support rural populations. A live poll during the webinar determined that just over half of attendees had already implemented CHWs as part of their care teams. If your organization has not yet incorporated CHWs into your strategy, you’re not alone. But this movement is moving fast, based on the vast potential it offers.

Highlights from the AHIP webinar can be found below. To see the full presentation, click here.

Defining the Role of a Community Health Worker

In practical terms, CHWs serve as an extra layer of support for patients. You could also think of them as a bridge. A CHW is a frontline public health worker who has a unique understanding of, and connection to, the local community and has deep knowledge of available resources to support the social needs their patients may have. CHWs form close bonds with their patients and build trust in a way that enables deeper connections with the rest of the care team. CHWs serve as an important advocate for their patients, ensuring their voices are heard and needs are met, both clinically and socially. CHWs also help in situations where patients don’t fully understand the directions they’ve been provided by doctors.

The CHW role is continually expanding to add more value. One example is in chronic disease support. In some settings, CHWs are being trained in the administration of diabetic retina exams. By facilitating these exams in the home, care gaps are effectively closed, and patients have a familiar face conducting the exam versus having to travel to a clinic.

Approaching Patients as People

When we think about health, we usually think about a new diagnosis or a chronic condition. We need to use a far wider lens. Health is about the whole person. It’s about the physical, emotional and social needs of each individual. There are so many factors that impact someone’s health status and many of them have nothing to do with a diagnosis code or a specific condition. Are there family dynamics at play? Is the patient in a safe environment? Are social needs being met? Are there mental health issues to address? This is where a CHW can be invaluable. This role provides that wider lens and a more complete view of the whole patient.

It’s Not Just Who, It’s Where

It’s important to remember that CHWs are recruited from the communities they serve, which means they look and speak like the patients they support and have a lot of context for the local area. This helps them better serve patients and more quickly build trust.

Just as importantly as who they are is where this support is being delivered. To get a full picture of what’s going on with a specific patient, you have to bring care to the place that individual calls home. By having CHWs connect with patients in their homes, you can really understand their specific challenges and more deeply engage with them. You have a much richer appreciation for the person you’re supporting, and how to help them, when you are in the home, versus sitting in a sterilized clinic.

Integrating CHWs into Care Teams

The most important place to start is ensuring your organization fully understands the role of a CHW and that you are equipped to invest in, and support, this role. Are you ready to integrate CHWs into your care team? Do you have a plan for training the extended team on the role CHWs will play and how to work effectively with them? It’s important that the rest of your staff understands CHWs are not just “helpers” but core team members who bring the voice of the patient to the table, as well as a unique understanding of each patient’s needs and barriers to care.

Once you have a clear plan for welcoming CHWs to the care team, make sure you are optimizing the CHW role using systems so that you can standardize as much as possible. In doing this, you’re looking to make this a role that can be scaled and leveraged consistently. You also want to ensure data and insights from CHW encounters are flowing back to the rest of the care team. Just be careful in this process that you don’t interfere with the CHWs’ ability to work their magic. You don’t want to overburden them with documentation or systems. This prevents them from doing their best work.

A final key to consider is recruiting. Great talent is always what organizations strive for, but in the CHW role we are looking at talent differently. When staffing CHWs, it’s important to hire for the heart and then train the brain. You should be focusing your search for talent on individuals who have the right raw materials, which includes passion and pride for their local community and a heart for service and people.

So, you’re aligning expectations and team culture, equipping and empowering success through the smart use of systems and recruiting the right talent to deliver on the promise of the CHW role. At the end of the day, what you’re trying to accomplish is facilitating a close partnership between the CHW and provider, so they can work together to better care for patients.

Want to hear more from this expert panel? Click here for the full webinar. Need guidance on how your organization can effectively deploy CHWs to enhance the care you provide to rural patients? Contact us today at for a 1:1 consultation.

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