1. (Definition) A community health worker, promotore, and community health representative (CHW/P/CHR) is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the worker to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services […] More

Developing Sufficient Rates. As of January 2025, there was significant variation in Medicaid payment rates for CHW/P/CHR services covered by state fee-for-service (FFS) programs, ranging from over $18 to $50 per 30 minutes.18 For comparison, the average national rate for 30 minutes of Medicare Community Health Integration services provided by a CHW is $48.52 in 2025.19 An analysis of […] More

Community health workers, promotores, and community health representatives have historically relied on a patchwork of grants for funding, but more than half of state Medicaid programs have now implemented some form of CHW/P/CHR coverage and payment policy. This toolkit provides model language for state Medicaid leaders and CHW/P/CHR advocates to use as they develop State Plan Amendments and accompanying guidance documents to establish coverage and payment for CHW/P/CHR services. More

in a new View from Here, Milbank Memorial Fund President Christopher Koller discussed the breakdown in the “rules of the road” that has led to declining vaccination rates among children. More

The Milbank State Leadership Network (MSLN) hosted two virtual sessions for state-to-state discussion on opportunities and strategies related to the federal Rural Health Transformation (RHT) Program, recently launched by the Centers for Medicare & Medicaid Services (CMS). More

This policy brief provides an overview of opportunities to improve state health care workforce data collection and analysis. More

The newly launched Rural Health Transformation Program (RHTP) invests $50 billion dollars towards strengthening health care across rural America, including by creating sustainable access to rural health care providers and improving workforce development. As states prepare proposals for the RHTP, they need a clear understanding of the workforce available to serve these populations, especially the primary care workforce available to rural Medicaid beneficiaries. More

Event date: September 11, 2025 Introduction The Milbank State Leadership Network hosted a virtual session for state legislative and executive branch staff with panelists from Heartland Forward, Common Health Coalition, and IMPaCT Care on lessons from recent efforts to strengthen community health worker (CHW) infrastructure. The discussion highlighted state legislation, public health and health care […] More

As of 2023, nearly 3 million children in the United States remained uninsured, largely due to immigration-related exclusions in public insurance programs like Medicaid and the Children’s Health Insurance Program (CHIP). In response, state policymakers have sought ways to close the gap on children’s coverage. More

As state policymakers apply for the OBBBA’s Rural Health Transformation funding, they have a significant opportunity to partner with their RPCUs to address the research, and especially, the workforce training needs of their rural communities. More