Date of Award

January 2024

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Gregg Gonsalves


Introduction: Community health workers (CHW) may contribute to increased Medicaid enrollment as well as increased uptake of preventative services in states that allow Medicaid reimbursement for CHW services. Reimbursement has been highlighted previously as a useful funding mechanism for CHW positions. This descriptive study aims to examine how CHWs are embedded in healthcare settings and how reimbursement may have altered how CHWs practice.Methods: An exploratory Qualtrics survey was distributed to CHW networks, CHWs, and Medicaid officials (MOs) in the United States from March to April 2024. A total of 58 respondents (50 CHWs and 8 MOs) were sampled and 16 different states were represented in the study. Descriptive statistics and bivariate analysis were used to characterize respondents’ beliefs and attitudes towards reimbursement, resources needed for CHW, and CHWs’ role in increasing Medicaid enrollment, preventing disenrollment, and increasing preventative service utilization. Results: We found that CHW were generally aware of whether their state currently reimbursed for CHW services and that CHW most commonly help patients navigate needed care (both healthcare and social programs). The need for consistent funding was echoed by survey respondents repeatedly and sustainable funding and reimbursement were cited by approximately half of respondents as the most needed resources for CHW in their state. CHWs in respondents’ states increase Medicaid enrollment, decrease Medicaid un-enrollment, and increase preventative services uptake. Conclusion: Reimbursement could help stabilize CHW funding and increase uptake of preventative services by Medicaid enrollees, increase Medicaid enrollment, and decrease Medicaid unenrollment. Further research should explore and quantify the impact of reimbursement on these outcomes.


This is an Open Access Thesis.

Open Access

This Article is Open Access