Community Research: Connecting the Underserved Saves Money

David Robinson

A few years ago, UAMS researchers   found that significant Medicaid savings were resulting from a unique effort to help people in three underserved counties receive in-home long-term care.

The savings – $2.6 million over three years – were accruing from a Community Connector Program based in Phillips, Lee and Monroe counties.

“The key is getting people the appropriate services so they can stay at home and prevent major health events.”
The outcome of that UAMS Fay W. Boozman College of Public Health study by Holly Felix, Ph.D., M.P.A., has led Medicaid to expand the Community Connector program from three counties to 15. The National Institutes of Health (NIH) through the College of Public Health’s Arkansas Center for Health Disparities is now supporting Felix’s analysis of the expanded program and its potential savings.  “It may seem counterintuitive that improving access to these services results in savings, but when you consider the high cost of  nursing home care, it really makes a difference,” said Kate Stewart, M.D., M.P.H., a College of Public Health researcher and director of the UAMS Translational Research Institute’s Community Engagement program. 

“The key is getting people the appropriate services so they can stay at home and prevent major health events that land them in the hospital or a nursing home.”

The Community Connector Program employs community health workers called Community Connectors who are selected from within the medically underserved communities targeted by the program. Their strong ties with neighbors, church leaders, schools, current and former co-workers, and employers and other organizations make them ideally suited for locating elderly and disabled people who need home and community-based services.

In the first known study of its kind, Stewart has been delving into how the community health workers find people who need services. The work is being done in collaboration with the Tri-County Rural Health Network, which manages the Community Connector Program.

With pilot funding from the UAMS Translational Research Institute through the National Center for Advancing Translational Sciences, she has examined the individual networks of five community health workers. Called social network analysis, the study also looked at the connections among each of the worker’s network contacts, determining whether they knew each other.

Though the study was small and couldn’t make definitive conclusions, Stewart said some social networks appeared to be more effective at finding people who need services. For example, those who did the best job of finding new cases were those who  had more network contacts who didn’t know each other.

She hopes to publish the pilot study data and that it will lead to a larger study that validates the findings. The information could guide training of community health workers, helping them become even better at finding people who need care. Potentially it could have national health policy implications.

“From a policy standpoint, we may be focused on cost-effective use of services,” Stewart said. “But for the individuals involved, it also means independence and better quality of life.”