The U.S. health care system is in dire need of new approaches to achieve better health outcomes at lower cost. Seventeen percent of the country’s GDP is spent on health care, yet it places 37th in international rankings of health care systems. In addition, health disparities abound. People of color and people with low incomes suffer disproportionately from disease and mortality.
In 1997, the Prevention and Access to Care and Treatment Project (PACT) recruited and trained community health workers (CHWs) to work with Boston’s most vulnerable HIV/AIDS population. These individuals suffer from mental illness, substance use, stigma, and poverty, and are dying despite readily available care and lifesaving medications. CHWs are trained to affect real change in patients’ self-management skills, health, and well-being.
By integrating CHWs into existing health systems, PACT has achieved the following transformative results:
- 16 percent reduction in Medicaid annual expenditure two years after patients’ enrollment in the HIV/AIDS program.
- 70 percent of patients enrolled in the HIV/AIDS program demonstrate improvements in HIV-related biomarkers.
- High-risk diabetic patients who received help from a community health worker demonstrated a statistically significant reduction (1 percent) in HbA1c (Hemoglobin A1c) after six months compared to those in standard care.
PACT now provides training and technical assistance to health care organizations interested in establishing community health worker and care management models to improve outcomes and decrease expenditures related to their most vulnerable and complex patients.
Today, PACT’s care model is seen as an innovative health care strategy that fulfills Partners In Health’s mission of empowering the vulnerable to reclaim their health and quality of life and offers a solution to achieving value and equity in the United States.
By the numbers
HIV patients served: 85
PACT-trained health care providers: 300
Community health workers employed by PACT: 9
Health promotion and directly observed therapy home visits: 5,160
(All numbers are for fiscal year 2011)