The Impact of State Certification and Medicaid Reimbursement on Community Health Worker Place of Employment and Wages: United States, 2012–2023.

Objectives. To describe trends in US community health worker (CHW) place of employment and wages and the impact of state certification programs and Medicaid reimbursement. Methods. Using 2012 to 2023 Bureau of Labor Statistics data, we performed tests of proportions to describe CHWs' changes in empl...

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Publicado en:American Journal of Public Health Vol. 116; no. 8; pp. 1198 - 1210
Autores principales: Mitchell, Lauren M., Tan, Marcia, Shad, Nayeli S., Thomas, Nikita, Wagner, Mary Kate, York, Elizabeth Blair, Huang, Elbert S., Cliff, Betsy Q.
Formato: Artículo
Publicado: American Public Health Association Aug2026
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2026
      vid: 116
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      pub: American Public Health Association
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        195376206
        10.2105/AJPH.2025.308416
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        atl: The Impact of State Certification and Medicaid Reimbursement on Community Health Worker Place of Employment and Wages: United States, 2012–2023.
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          Mitchell, Lauren M.
          Tan, Marcia
          Shad, Nayeli S.
          Thomas, Nikita
          Wagner, Mary Kate
          York, Elizabeth Blair
          Huang, Elbert S.
          Cliff, Betsy Q.
        affil:
          Section of General Internal Medicine, University of Chicago, Chicago, IL.
          Department of Public Health Sciences, University of Chicago, Chicago, IL.
          Biological Sciences Division, University of Chicago, Chicago, IL.
          Liaisons in Care Community Health Worker Program, Urban Health Initiative, University of Chicago Medicine, Chicago, IL.
      su:
        Washington (D.C.)
        United States
        Wages
        State governments
        Medicaid
        Employment
        COVID-19 pandemic
        Health insurance reimbursement
        Research funding
        Certification
        Descriptive statistics
        Data analysis software
        Confidence intervals
        Regression analysis
      sug:
        subj:
          Wages
          State governments
          Medicaid
          Employment
          COVID-19 pandemic
          Washington (D.C.)
          United States
          Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs)
          Health insurance reimbursement
          Research funding
          Certification
          Descriptive statistics
          Data analysis software
          Confidence intervals
          Regression analysis
      ab: Objectives. To describe trends in US community health worker (CHW) place of employment and wages and the impact of state certification programs and Medicaid reimbursement. Methods. Using 2012 to 2023 Bureau of Labor Statistics data, we performed tests of proportions to describe CHWs' changes in employment in different industries, linear regression to compare their wages between industries, and staggered difference-in-differences to evaluate the impact of certification and Medicaid reimbursement on the proportion of CHWs in each industry and wages. Results. CHW employment in health care and government has increased (P <.001), and CHWs are paid the least in social assistance agencies (P <.001). Certification was associated with a decreased proportion of government and public health CHWs (−9.4%; P =.003) but was not associated with wages. Medicaid reimbursement was not associated with place of employment or wages. Conclusions. Substantial wage differences exist across industries employing CHWs, and neither Medicaid reimbursement nor certification was associated with higher wages. Certification may influence workforce distribution, particularly in government settings. Public Health Implications. Improved Medicaid reimbursement rates and billing procedures and optimized payment models could grow and sustain the CHW workforce. Decreases in government employment after certification warrant further research. (Am J Public Health. 2026;116(8):1198–1209. https://doi.org/10.2105/AJPH.2025.308416)
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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