TY - JOUR
AU - A. Vasan
AU - M. Knowles
AU - S. Flerchinger
AU - T. K. Tandy
AU - D. Mosen
AU - J. Soltesz
AU - O. Paradis
AU - N. Friedman
AU - J. A. Long
AU - B. L. Ertz-Berger
AU - S. Kangovi
A1 - 
AB - BACKGROUND: Community health worker (CHW) interventions can improve health outcomes and reduce acute care utilization. Few prior studies have examined the association of CHW interventions with health care utilization among patients within an integrated health system. OBJECTIVE: To evaluate the effects of Individualized Management for Patient Centered Targets (IMPaCT), a standardized CHW intervention originally developed within a single health system in Philadelphia, PA, on acute care utilization and primary care engagement among low-income patients at two clinics within an integrated health system in Portland, Oregon. DESIGN: Prospective randomized analysis using adjusted difference-in-differences regression. PARTICIPANTS: In total, 1230 adults living in low-income zip codes were randomized using a 2:1 allocation sequence to receive either IMPaCT (n = 820) or usual care (n = 410). INTERVENTIONS: IMPaCT is a standardized intervention in which CHWs use an in-depth interview to understand patients' strengths, social needs, and health-related goals and then collaboratively develop tailored action plans. Over 3 months, CHWs communicated with patients at least once weekly to provide coaching, social support, and navigation tailored to their goals. Due to the COVID- 19 pandemic, the intervention was predominantly delivered remotely. MAIN MEASURES: Primary outcome measures were hospital and emergency department (ED) utilization, both measured per 1000 members per month, and proportion of patients with 1+ primary care visits. Implementation fidelity and maintenance were also assessed. KEY RESULTS: Compared to usual care, patients who received IMPaCT had a relative reduction in total hospital days at 6 months (- 172.3 days per 1000 members per month, 95% CI - 320.05 to - 24.53, p= 0.022), and a greater proportion attended 1+ primary care visits (85.7% vs. 79.5%, p= 0.006). There were no differences in ED utilization. CONCLUSIONS: A standardized CHW intervention delivered remotely within an integrated health system during the COVID- 19 pandemic was associated with decreased hospital utilization and improved primary care engagement.
AD - Division of General Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. vasana@chop.edu.; Penn Center for Community Health Workers, University of Pennsylvania Health System, Philadelphia, PA, USA. vasana@chop.edu.; PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA. vasana@chop.edu.; Penn Center for Community Health Workers, University of Pennsylvania Health System, Philadelphia, PA, USA.; Division of General Internal Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.; Kaiser Permanente Northwest Population Health, Portland, OR, USA.; Kaiser Permanente Center for Health Research, Portland, OR, USA.; Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA.; IMPaCT Care, Philadelphia, PA, USA.
AN - 40216669
BT - J Gen Intern Med
C5 - Education & Workforce
CP - 2
DA - Jan
DO - 10.1007/s11606-025-09495-6
DP - NLM
ET - 20250411
IS - 2
JF - J Gen Intern Med
LA - eng
N2 - BACKGROUND: Community health worker (CHW) interventions can improve health outcomes and reduce acute care utilization. Few prior studies have examined the association of CHW interventions with health care utilization among patients within an integrated health system. OBJECTIVE: To evaluate the effects of Individualized Management for Patient Centered Targets (IMPaCT), a standardized CHW intervention originally developed within a single health system in Philadelphia, PA, on acute care utilization and primary care engagement among low-income patients at two clinics within an integrated health system in Portland, Oregon. DESIGN: Prospective randomized analysis using adjusted difference-in-differences regression. PARTICIPANTS: In total, 1230 adults living in low-income zip codes were randomized using a 2:1 allocation sequence to receive either IMPaCT (n = 820) or usual care (n = 410). INTERVENTIONS: IMPaCT is a standardized intervention in which CHWs use an in-depth interview to understand patients' strengths, social needs, and health-related goals and then collaboratively develop tailored action plans. Over 3 months, CHWs communicated with patients at least once weekly to provide coaching, social support, and navigation tailored to their goals. Due to the COVID- 19 pandemic, the intervention was predominantly delivered remotely. MAIN MEASURES: Primary outcome measures were hospital and emergency department (ED) utilization, both measured per 1000 members per month, and proportion of patients with 1+ primary care visits. Implementation fidelity and maintenance were also assessed. KEY RESULTS: Compared to usual care, patients who received IMPaCT had a relative reduction in total hospital days at 6 months (- 172.3 days per 1000 members per month, 95% CI - 320.05 to - 24.53, p= 0.022), and a greater proportion attended 1+ primary care visits (85.7% vs. 79.5%, p= 0.006). There were no differences in ED utilization. CONCLUSIONS: A standardized CHW intervention delivered remotely within an integrated health system during the COVID- 19 pandemic was associated with decreased hospital utilization and improved primary care engagement.
PY - 2026
SN - 0884-8734 (Print); 0884-8734
SP - 383
EP - 390+
ST - Effects of a Standardized Community Health Worker Intervention on Health Care Utilization Within an Integrated Delivery System
T1 - Effects of a Standardized Community Health Worker Intervention on Health Care Utilization Within an Integrated Delivery System
T2 - J Gen Intern Med
TI - Effects of a Standardized Community Health Worker Intervention on Health Care Utilization Within an Integrated Delivery System
U1 - Education & Workforce
U3 - 10.1007/s11606-025-09495-6
VL - 41
VO - 0884-8734 (Print); 0884-8734
Y1 - 2026
ER -