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CareOregon, community-based nonprofits codesign payment model to grow Traditional Health workforce

Over the past two years, CareOregon has worked closely with eight community-based nonprofits in the Metro region through the Traditional Health Workers Grant Program, investing $800,000 to develop a more sustainable way to pay Traditional Health Workers (THWs) that helps support and grow their workforce.

“Communities know best how they best receive services," said Shawn DeCarlo, Director of Community Impact at CareOregon. “Traditional Health Workers are a big part of our health system and are often most in touch with their communities. This 2-year grant program to support this workforce was essential to understanding how CareOregon can better meet people where they’re at and better support community-based organizations to provide services that best fill the community's needs.”  

Traditional Health Workers play a crucial role in health care, especially in the area of social health, in that they bridge the community and the health system. THWs provide person-centered care and are often from the communities they serve—they are able to speak the language, interact in the culture and encourage people to become advocates in their care. As a result, they can reach individuals and families that have been historically underserved  and have difficulty accessing and navigating the health care system. 

"If you consider the populations that Traditional Health Workers serve—the historically underserved—these are folks who are likely to fall through the cracks in our very fragmented health care system,” said Ifeoma Muoto, Director of Community Health Partnerships at CareOregon. “And so the value of this workforce is really in promoting equity, which is something that for many organizations, including ours, is central to what we do."

Traditional Health Workers have been shown to improve health outcomes, increase access to social supports and resources, and support greater overall wellbeing. But so often community-based organizations don't have the consistent funding to hire, train and grow their workforce. The goal of the grant program is to develop a contracting approach to support payment for services that THWs provide to members and the community, reducing disparities and improving accessibility and member health.

"We have been using Traditional Health Workers for years, but grants come and grants go,” Holden Leung, CEO of the Asian Health & Service Center. “The question is how to sustain and grow the Traditional Health Worker so that they become recognized as an important part of the health care system? This grant and this partnership gives hope that we can continue to build this workforce so that they really can be supported in the long term and our communities can become healthier because of it.”

About Traditional Health Worker Grant Program

During the two-year program, CareOregon collaborated with eight community-based nonprofits: Asian Health & Service Center, Doulas Latinas, Familias en Accion, IRCO, NAYA, Our Just Future, Parrot Creek and Straightway Services.  

CareOregon, worked alongside these organizations to better understand the barriers to sustaining and growing this workforce and collaborated on ways to best overcome them. We started by learning more about services these essential workers provide and the populations they serve. Participating organizations and CareOregon used this shared understanding to codesign a payment model that recognizes the unique value of Traditional Health Workers and allows our partners to sustain and grow their THW workforce.

"Developing a sustainable payment model like this is critical because Traditional Health Workers are the social health workforce,” said Amie Diffenauer, Community Programs Manager at Our Just Future. “This program really allowed us to help start to build that workforce and to really recognize it for what it is. These are not just organizations doing good in the community. They are a workforce solving social health barriers and meeting social needs."

CareOregon will continue to learn alongside these partners how our contracting approach can help support and sustain the Traditional Health Workers workforce and improve member outcomes and experience. 

As of December 2022, CareOregon signed contracts with four of our community-based partners—Asian Health & Service Center, Familias en Accion, IRCO and Our Just Future—to begin to use this new payment service model.

"This CareOregon program has provided an opportunity for the partners involved to build more capacity and to rethink and expand the quality of Traditional Health Worker services,” said Jaeme Miranda, Director of Community Health Worker Services at Familias en Accion.

“For us at Familias in particular, the consistent funding and support from CareOregon has helped us be better able to provide training and support for our community health workers and really recognize the expertise of Traditional Health Workers and the impact they have on the health of the community members we serve.”

Who are Traditional Health Workers?

Traditional Health Workers is an umbrella term that includes community health workers, peer support specialists, peer wellness specialists, personal health navigators and birth doulas.

They assist members in getting services and care that support and impact their overall health and wellbeing through helping them navigate the health system, connecting them to resources and social services that best fit their needs and providing cross-cultural communication and health education. 

"Traditional Health Workers help people access the social services and health care they need to improve their overall wellness,” said Stephanie Auxier, Population Health Portfolio Manager at CareOregon. “Families who just immigrated to the United States, for example, don't always know how to access the care and resources they need when they get here. Traditional Health Workers then come in to work with them on the individual level, acting as their partner through the entire process.”

Traditional Health Workers also help others within the health care system such as nurses, doctors and other organizations working to support the community, better understand the people they serve.

“It's hard to imagine how we would achieve health equity without resources like this,” Muoto said. “Another thing to keep in mind is Traditional Health Workers are not just in our clinics, specifically in this grant, they were out in the community. This is one way to really reach our communities. This is one way to advance engagement and to help educate the community about the variety of benefits and programs that exist. This is how we help build a healthy community, together.”