Thread by @ShreyaKangovi

Feb @Health_Affairs is out!

We did a formal return on investment (ROI) analysis of the IMPaCT community health worker program using randomized controlled trial evidence.

Each dollar invested by Medicaid returns $2.47, annually.

bit.ly/2QNt4v4

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This paper is important because most estimates of ROI from #SDOH programs are likely exaggerated because they are based on pre-post studies.

It’s important to note that IMPaCT is highly structured with fixed caseloads, clear hiring protocols and good supervision. I think those program elements are key to seeing this kind of financial return. So #hclrds, resist the impulse to skimp!

Also important to say: We never set out to “keep patients out of the hospital”.

IMPaCT #chws just help patients do what *they* wanted to do. But fortunately this patient-centered approach also appears to be financially sustainable.

It was a long, arduous and frankly very scary process to put our program to the test this way.

I honestly wasn’t sure what we would find —especially since we offered the program to a broad population with relatively low baseline cost.

In the end, I think we have a high degree of certainty that this investment returns more than most stocks!

While also doing good.

I am an idealistic pragmatist, so I’m pleased to see this ROI because it is the currency of the world.

But as my coauthor and mentor David Asch wrote, let’s remember that patients “measure value in units that are almost always off the books.”