Data on Managed Care Detailed by Researchers at Louisiana State University (Uptake of Medicaid Billing for Community Health Worker Services In Louisiana, 2022-2023): Managed Care

2025 DEC 05 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- A new study on Managed Care is now available. According to news reporting originating from New Orleans, Louisiana, by NewsRx correspondents, research stated, “In 2022, Louisiana Medicaid began offering reimbursement for some community health worker (CHW) services ordered and billed by a supervising clinician. We analyzed the extent to which CHW services were reimbursed by Louisiana Medicaid during 2022-2023, including number of encounters, demographics of Medicaid members served, number of encounters per member, geographic distribution of CHW encounters, primary diagnosis of members receiving CHW services, and provider type billing for CHW services.”

Financial support for this research came from Louisiana Medicaid.

Our news editors obtained a quote from the research from Louisiana State University, “Retrospective cohort study of Louisiana Medicaid members receiving CHW services reimbursed by Medicaid. We included paid fee-for-service claims and managed care encounters for CPT codes 98960, 98961, or 98962 with dates of service from 1/1/2022 through 12/31/23. A total of 10,726 unique individuals received 17,373 reimbursed CHW services, with an estimated total reimbursement of $314,905.52. Medicaid members ranged from 0 to 88 years, were majority female (56.8%), and received between 1 and 13 services; mean: 1.6 (SD: 1.1), median: 1 (IQR 1-2 encounters). The highest rate of CHW services per Medicaid member occurred in urban areas. Nearly all (99.97%) were individual services. A total of 41.9% of services were for screening without a specified diagnosis, and health-related social needs were more common than medical conditions. Over half (60.6%) of CHW services were billed by family practice or internal medicine providers. Health care practices may be asking CHWs primarily to conduct screenings, rather than provide the longitudinal services CHWs traditionally offer. Uptake of billing for CHW services was limited.”

According to the news editors, the research concluded: “Providers may need education about CHW roles and technical assistance to support CHW integration and billing.”

This research has been peer-reviewed.

For more information on this research see: Uptake of Medicaid Billing for Community Health Worker Services In Louisiana, 2022-2023. Medical Care, 2025;63(12):936-940. Medical Care can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Lippincott Williams and Wilkins - www.lww.com; Medical Care - http://journals.lww.com/lww-medicalcare/pages/default.aspx)

The news editors report that additional information may be obtained by contacting Ashley Wennerstrom, Louisiana State University, Ctr Healthcare Value & Effectiveness, Health Sciences Center, New Orleans, LA 70112, United States. Additional authors for this research include Chris Adkins, Marcus A. Bachhuber, Kelsey Witmeier, Angel Whittington and Catherine G. Haywood.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1097/MLR.0000000000002216. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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