Community Health Workers: A Review of Program Evolution, Evidence on Effectiveness and Value, and Status of Workforce Development in New England

Disparities across racial and socioeconomic lines in the utilization of health care services and in patient outcomes continue to plague healthcare systems in the U.S. (AHRQ, 2008; Smedley, 2003; Children’s Defense Fund, 2006). Policies to address health care disparities have varied, including steps to increase access to health insurance coverage at both the state and federal levels, policies aimed at increasing the diversity and numbers of primary care practitioners, and a multiplicity of programs aimed at coordinating care across settings and provider types, including disease management, case management, and multi-disciplinary clinics (Smedley, 2009).

The goal of this initiative is to provide a forum in which all these different strands of evidence, information, and public and private values can be discussed together, in a public and transparent process. Initially funded by a three-year grant from the federal Agency for Healthcare Research and Quality (AHRQ), and backed by a consortium of New England state policymakers, the mission of the New England Comparative Effectiveness Public Advisory Council (CEPAC) is to provide objective, independent guidance on how information on comparative effectiveness can best be used across New England to improve the quality and value of health care services. CEPAC is an independent body composed of clinicians and patient or public representatives from each New England state with skills in the interpretation and application of medical evidence in health care delivery. Representatives of state public health programs and of regional private payers are included as ex-officio members of CEPAC. The latest information on CEPAC, including guidelines for submitting public comments, is available online: cepac.icer-review.org.