PIH’s domestic project will take the stage in front of a global audience on September 20. At this year’s Clinton Global Initiative (CGI) Annual Meeting in New York City, Dr. Heidi Behforouz, founder and executive director of PIH’s Boston-based Prevention and Access to Care and Treatment (PACT) Project, will present a commitment to action that outlines a strategy for integrating community health workers (CHWs) into health systems across the country.
The three-day event is an opportunity for participants like Dr. Behforouz to build partnerships with politicians, activists, academics, and other NGOs. Fellow participants at this year’s CGI include Madeleine K. Albright, Tony Blair, Ted Turner and PIH cofounder Dr. Paul Farmer. See a list of featured attendees.
Since 2005, CGI has brought together nearly 150 current and former heads of state, 18 Nobel Prize laureates, and influential people across fields. CGI members have made nearly 2,000 commitments, which have already improved the lives of 300 million people in more than 180 countries. When fully funded and implemented, these commitments will be valued in excess of $63 billion.
Outlining and enacting steps towards change
Both on stage and while talking with fellow participants, Dr. Behforouz will focus on the three points foundational to PACT’s commitment to action.
- Creating a tool kit (training manual, patient intervention guides, operations manual) that both trains CHWs and provides technical assistance to health care organizations as they incorporate CHWs into their model of care
- Partnering with health care organizations across the US to pilot and scale an integrated CHW project during the next 3 years
- Leveraging PIH’s reputation, as well as partnerships with Harvard Medical School, Harvard School of Public Health, and experts throughout Massachusetts to establish cross-disciplinary and rigorous evaluations and analyses of the pilot
These three goals represent a significant change in PACT’s efforts to expand the impact of well-supported and well-integrated CHWs to transform health care delivery for the most vulnerable, complex, and costly patients.
PACT, which is supported by both PIH and the Division of Global Health Equity at Brigham and Women's Hospital, has already had a proven track record in success. Read a New York Times piece by Pulitzer Prize-winning author Tina Rosenberg which chronicles the efforts of a New York-based program modeled after PACT.
Lessons learned treating at-risk patients
For the past 15 years PACT has employed CHWs to improve the health outcomes and quality of life for some of Boston’s most vulnerable populations. CHWs work with the hardest-to-reach patients – individuals who suffer from mental illness, substance use, stigma, social isolation, and poverty and who are suffering and dying from despite readily available care and life-saving medication.
CHWs not only save lives, but they streamline health care, reduce redundancies, and save money. One year post-enrollment in PACT’s HIV program, 70 percent of patients witness significant improvement in their health (viral load suppression and CD4 improvements). Analysis of Medicaid claims reveals a 16 percent net savings in total medical expenditure two years after enrollment. This is attributed to a 35 percent reduction in length of stay and inpatient costs.
With health care reforms a major topic in the US, PACT hopes their CHW model will serve as a guide to existing health systems currently treating at-risk patients.
Historically a direct service project, PACT will now focus on providing training and technical assistance to forward-thinking health systems that wish to better accompany their most vulnerable patients to better health and quality of life.
PACT’s new consultancy model will enable broader impact of the CHW model as a solution for the rising disparities in domestic health care outcomes. This new initiative will build clinic capacity for team-based care, data-driven population management, dynamic management skills, and continuous quality improvement prior to integrating the CHW.
PACT is working to identify a community health center for a three-year pilot of its CHW-driven care management model.