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Updates and FAQs: Developing and Implementing a Medicaid State Plan Amendment to Authorize Community Health Worker Reimbursement

NASHP

Authority refers to the section of Medicaid regulations that the state used for the SPA. Eligible primary care practices must engage CHWs starting in 2024. Eligible primary care practices must engage CHWs starting in 2024. It is a primary care population-based payment (PBP) model.

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National Care Coordination Standards for Children and Youth with Special Health Care Needs (CYSHCN) Implementation Guide

NASHP

Shared Plan of Care. Care Coordination Workforce. Care Transitions. health plans, providers, families of CYSHCN) in using, adapting, and implementing the National Care Coordination Standards for CYSHCN to develop or improve care coordination systems. Team-Based Communication. How to Use This Guide.

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State Community Health Worker Models

NASHP

ACO Accountable Care Organizations. CBCM Community Based Care Management Program. PCCM Primary Care Case Management. PH-MCO Physical Health Managed Care Organization. RAE Regional Accountable Entity. Acronym Guide. APM Alternative Payment Model. CBO Community Based Organization.

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Community Health Worker Models

NASHP

The Department of Health Care Policy and Financing (the Medicaid program administrator) does not specifically require the Regional Accountable Entities (RAEs), care coordinating entities contracted with Colorado’s Medicaid program, or other managed care entities to cover CHW services, nor does the Department pay for CHW services under FFS.