Medicaid MCOs Deploy Community Health Workers to Close Pediatric Care Gaps

Community health workers (CHWs) are emerging as a strategic tool for Medicaid managed care organizations to address missed well-child visits, immunization delays, and undiagnosed chronic conditions in pediatric populations. CHWs connect families to care by addressing social determinants and system navigation barriers that fragment service delivery. For MCOs, CHW programs offer a mechanism to improve HEDIS measures, close pediatric quality gaps, and meet contractual performance targets while addressing upstream factors that drive preventable utilization. State Medicaid agencies are increasingly encouraging or requiring MCO investment in CHW models as part of value-based care strategies.

Managed Care · Maternal · CHIP