Hourly Wages and Turnover of Community Health Workers According to US State Certification Policy and Medicaid Reimbursement, 2010–2021

Author:

Jones Tammie M.1,Jeung Chanup1,Schulte Alex1,Lewis Charlotte M.1,Maddox Peggy J.1

Affiliation:

1. Tammie M. Jones, Alex Schulte, Charlotte M. Lewis, and Peggy J. Maddox are with the Department of Health Administration and Policy, George Mason University, Fairfax, VA. Chanup Jeung is with the Department of Health Promotion and Policy, University of Massachusetts Amherst.

Abstract

Objectives. To evaluate the effects of state community health worker (CHW) certification programs and Medicaid reimbursement for CHW services on wages and turnover. Methods. A staggered difference-in-differences design was used to compare CHWs in states with and without CHW certification or CHW Medicaid reimbursement policies. Data were derived from the 2010 to 2021 Current Population Survey in the United States. Results. CHW wages increased by $2.42 more per hour in states with certification programs than in states without programs (P = .04). Also, hourly wages increased more among White workers, men, and part-time workers (P = .04). Wages increased by $14.46 in the state with the earliest CHW certification program adoption (P < .01). Neither of the policies assessed had an effect on occupational turnover. Conclusions. CHW wages are higher in states with certification programs. However, wage gaps exist between Whites and non-Whites and between men and women. Public Health Implications. Federal, state, and employer-based strategies are needed to establish and sustain effective CHW programs to meet the needs of communities experiencing health and access disparities. (Am J Public Health. 2022;112(10):1480–1488. https://doi.org/10.2105/AJPH.2022.306965 )

Publisher

American Public Health Association

Subject

Public Health, Environmental and Occupational Health

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