By Myra Guevara, Research Intern
Rising health care costs is one of the biggest challenges we are facing as a nation. The fast increasing costs in this arena are jeopardizing our businesses and government’s future, with outrageous rates of growth that are virtually unsustainable. In this climate, there are some who are taking risks and trying new strategies to bring down the costs of health care.
At the heart of the health care cost problem is that many of the most expensive patients to cover use emergency facilities as their primary source of health care. Many also suffer from chronic diseases that could have been treated earlier if the proper preventative measures had been taken. Unfortunately, emergency facilities are great for accidents but are not equipped to deal with complex, long-term health issues. They also increase costs exponentially when compared to a patient who sees a primary care doctor regularly.
This leads to an endless cycle of doctors’ visits, unnecessary tests, and thousands of dollars in care. These patients, often referred to as “super-users” can account for a huge percentage of a business or organizations health care costs each year, making it difficult for small business to provide affordable benefits.
One of the old models that is being adopted to address these issues is the promotora model of care. Promotora is a spanish word that in the US, is often referred to as community health workers, health coach workers and health promoters. However, the core concept remains the same. It brings members of the community who are not health professionals and integrates them into patient care in a central way. A main aspect of promotoras/es’ work is to educate the community about the services that they can access and to provide support to community members who because of language or cultural barriers.
In a report released last year by NLIRH on the promotora model of care, Promotoras/es were defined as: “community members who promote health in their own communities. They provide leadership, peer education, and resources to support community empowerment, or capacitación.” Promotoras/es visit target patients more frequently, stay on top of their medication, speak their language and often times can share similar experiences from their own lives.
A recent New Yorker article by Atul Gawande brought the benefits of integrating a promotora model of care to the forefront of the health care conversation. His research showed that providers who integrated this health workers into their practices to provide this additional support showed impressive decreases in the cost of care for the most expensive patients.
NLIRH has worked closely with promotoras in the Lower Rio Grande Valley promoting the role they play in quality healthcare for immigrant communities and advancement of reproductive justice for Latinas. It is great to see the Promotora model getting the attention it deserves for improving health care.
By Myra Guevara, Research Intern
