Measuring return on investment of outreach by community health workers.

Community health workers (CHWs) are effective in improving access to health care, promoting client knowledge and behavior change, and contributing to improved health status of individuals. However, few outreach programs have evaluated the financial impact of CHWs on health care systems and policies. A longitudinal repeated measures design was used to assess the return on investment (ROI) of outreach by CHWs employed by Denver Health Community Voices. Service utilization, charges and reimbursements for 590 underserved men were analyzed 9 months before and after interaction with a CHW. Primary and specialty care visits increased and urgent care, inpatient, and outpatient behavioral health care utilization decreased, resulting in a reduction of monthly uncompensated costs by $14,244. Program costs were $6,229 per month and the ROI was 2.28:1.00, a savings of $95,941 annually. These data provide evidence of economic contributions that CHWs make to a public safety net system and inform policy making regarding program sustainability.