Sustainable Financing for Peer Support Within Reach

 Peers for Progress Newsletter
                          May 21, 2014
For a long time, peer support programs have been funded by a patchwork of short-term grant funding. Within the past ten years, states have started to recognize the benefits of financing peer support programs through dependable channels of reimbursement. Our spotlight this month looks at sustainable financing models for peer support and key trends to watch for in the future. Additional information on financing may be found in the program resources section.

Follow us on Twitter (@Peers4Progress) to stay up to date with the latest research and trends in the field of peer support.


Sustainable Financing for Peer Support Within Reach

In the United States, the most pressing challenge for the majority of CHW programs is the ability to obtain reliable funding. Programs move forward, one grant cycle after another, by piecing together a patchwork of short-term grant funding. In recent years, however, public and political support for CHWs is nearing a tipping point that could herald the dawn of sustainable financing. Our spotlight this month looks at the financing models out there right now and key trends to watch for in the future. [Read more]

2014 Together on Diabetes Grantee Summit

In February 2014, the Bristol-Myers Squibb Foundation convened the third Together on Diabetes Grantee Summit. Peers for Progress presented on our collaborative project with Alivio Medical Center and the National Council of La Raza, which demonstrated the feasibility of a population-based, promotore de salud program in a Latino community.

Visit the Together on Diabetes website to find the Summit Report, presentation slides, speaker videos, grantee posters and skill building workshop materials.

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Program Resources    

Advancing Community Health Worker Practice and Utilization: The Focus on Financing

This report from the Center for the Health Professions at UCSF identified and describes sustainable financing models for CHWs, including a number of examples, best practices and promising directions. [Read more]

An Action Guide on Community Health Workers: Guidance for Health Insurers

This action guide provides a list of specific evidence-based action steps and resources that insurers can use to improve patient outcomes and the overall value of CHW services. It delineates possible quality indicators for CHW programs and describes policy experts’ experiences and perspectives on options for reimbursement. [Read more]

Medicaid Funding of Community-Based Prevention: Myths, State Successes Overcoming Barriers and the Promise of Integrated Payment Models

The complexity of Medicaid program rules and some features of prevention initiatives lead to myths about what federal rules will allow Medicaid to cover. This brief examines key myths about Medicaid financing of community-based prevention and state examples that debunk these myths. [Read more]

Perspectives on the Evolution and Future of Peer Recovery Support Services

This SAMHSA publication looks at the past and future of peer recovery support services, including sustainable financing and opportunities in the Affordable Care Act. See Section 3 starting on page 15 for perspectives on financing. [Read more]

Research Briefs 

CHWs and the Affordable Care Act: An Opportunity for a Research, Advocacy, and Policy Agenda

To date, there has been limited policy guidance, support, or evidence on how best to integrate CHWs into the health system on a large scale. The Affordable Care Act, through several provisions, provides a unique opportunity to create a unified framework for workforce integration and wider utilization of CHWs. This review identifies four major opportunities to further the research, advocacy, and policy agenda for CHWs and recent evidence for each of the opportunities. [Abstract]

Feasibility and Evaluation of a Pilot CHW Intervention to Reduce Hospital Readmissions

A randomized quality improvement intervention was conducted at an academic medical center in Boston, MA and 10 affiliated primary care practices. The participants (n=423) were discharged to home and had one of five risk factors for readmission within 30 days. Roughly 70% of patients received at least one post-discharge CHW call and only 38% received at least calls as intended. While readmission rates were lower among CHW patients (15.4%) compared to usual care (17.9%), the difference was statistically significant. An ongoing RCT based on this pilot will provide further insight into this approach. [Abstract]

The Impact of Medicaid Peer Support Utilization on Cost

The purpose of this study was to fill gaps in the literature related to peer support programs and cost: lack of comparison groups, small sample sizes, and the availability of research examining utilization of Medicaid mental health services. Peer support was associated with $5,991 higher total Medicaid cost (p<.01), $2,100 higher prescription drug cost (p<.01), $5,116 higher professional services cost (p<.01), and $1,225 lower facility cost (p<.01). While Medicaid financed peer support is not cost-saving, it effectively supports the principles of self-direction and recovery from serious mental illness. State policy makers must weigh the potential higher cost associated with peer support programs with efforts to redesign the delivery of mental health services. [Abstract]

Comparative Effectiveness of Peer Leaders and CHWs in Diabetes Self-management Support: Results of a RCT

Peers for Progress grantees at the University of Michigan compared a peer leader (PL) versus a CHW telephone outreach intervention in sustaining improvements in HbA1c over 12 months after a 6-month diabetes self-management education program. Both low-cost maintenance programs led by either a PL or a CHW maintained improvements in key patient-reported diabetes outcomes, but the PL intervention may have additional benefit in sustaining clinical improvements beyond 12 months. [Abstract]

A Demonstration of Peer Support for Ugandan Adults with Type 2 Diabetes

A Peers for Progress demonstration grant reports that a short-term (4 months) peer support program was a feasible intervention to improve diabetes care in rural Uganda. Participants were successfully recruited and retained, and they experienced positive behavioral and physiologic outcomes (HbA1c, diastolic blood pressure, and eating behaviors). Elements of the intervention were sustained 18 months after the intervention. [Abstract]

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Funding Opportunities 

Family-Centered Self-Management of Chronic Conditions (R21
Deadline: June 16, 2014
Funds: $275,000 total / 2 years

The purpose of this FOA is to encourage research that seeks to build the science of family-centered self-management (FCSM) in chronic conditions. FCSM recognizes and addresses family needs and preferences, and integrates family members as partners in care while promoting individual self-management. [Read more]

Community Partnerships to Advance Research (R01)
Deadline: June 5, 2014
Funds: Not limited / Max 5 years

The purpose of the funding opportunity is to stimulate researchers to partner with communities using Community Engaged Research (CEnR) methodologies that will enhance relationships leading to better interventions and positive health outcomes. [Read more]

Targeted Basic Behavioral and Social Science and Intervention Development for HIV Prevention and Care (R01)
Deadline: May 7, 2014
Funds: Not limited / Max 5 years

This FOA encourages research designed to (a) conduct basic behavioral and social science research that is needed to advance the development of HIV prevention and care interventions, (b) translate and operationalize the findings from these basic studies to develop interventions and assess their feasibility and (c) conduct tests of the efficacy of HIV prevention and care interventions [Read more]

Behavioral Interventions to Address Multiple Chronic Health Conditions in Primary Care (R01)
Deadline: June 5, 2014
Funds: Not limited / Max 5 years

This FOA will support research in primary care that uses a multi-disease care management approach to behavioral interventions with high potential impact to improve patient-level health outcomes for individuals with three or more chronic health conditions. The proposed approach must modify behaviors using a common approach rather than administering a distinct intervention for each targeted behavior and/or condition. [Read More]

Prevention and Treatment of Obesity, Diabetes, and Chronic Kidney Disease in Military Populations (R01)
Deadline: June 14, 2014
Funds: Not limited / Max 5 years

The goal of this FOA is to encourage applications on prevention and treatment of obesity, diabetes, and chronic kidney disease in military personnel (active duty and retired) and their families. [Read More]


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Program Resources

Research Briefs

Funding Opportunities

Meetings and Events

  Please forward this e-newsletter to an interested colleague 

Sustainable Financing for Peer Support Within Reach

2014 Together on Diabetes Grantee Summit


PCPCC Western Regional Conference (June 9-10 in Denver, CO)

ADA 74th Scientific Sessions (June 13-17 in San Francisco, CA)

NCLR National Conference (July 19-22 in Los Angeles, CA)

AADE Annual Meeting (August 6-9 in Orlando, FL)

NACHC Community Health Institute & Expo (August 22-26 San Diego, CA)




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