CHW Contacting Vendors

Third-party contractors for Community Health Worker (CHW) services are external, independent organizations—often Community-Based Organizations (CBOs) or non-profits—that health plans, hospitals, or government entities hire to deliver frontline public health and social support services to the targeted population. 


Why Health Systems Use Third-Party CHW Contractors?


Large health systems, state agencies, and Managed Care Organizations (MCOs) use contractors for several reasons: 

  • Community Trust: Contractors are deeply rooted in the communities they serve. Because CHWs typically share lived experiences with the population, they build trust that traditional clinical settings often lack.
  • Social Determinants of Health (SDOH): Contractors focus on non-medical needs that impact health, such as housing assistance, food insecurity, and system navigation.
  • Administrative Offloading: Clinical entities (like hospitals) may lack the infrastructure to efficiently bill public programs for social outreach. Contracting out allows them to delegate this specialized outreach. 

Typical Contracting Models

  • Direct CBO Contracting: A state Medicaid program or health plan contracts directly with a CBO to provide CHW services to its members.
  • Hub-and-Spoke Model: A larger "hub" entity holds the primary contract with the health plan or government and handles the heavy administrative tasks (like credentialing and claims). The hub then subcontracts with local CBOs and individual CHWs who do the on-the-ground work. 

Services Provided

When acting as a contracted third party, CHWs typically deliver services within the following domains: 

  • Health Navigation: Helping patients schedule appointments, secure transportation, and understand their health benefits.
  • Care Coordination: Bridging the gap between patients, primary care teams, and local social services.
  • Health Education: Culturally competent education on chronic disease management and preventive care. 

Local Regulatory Context (Utah)

In Utah, CHW services are a rapidly evolving part of the health care landscape, driven by statewide workforce development and integration goals. If you are working within this space in Utah, it is helpful to understand the Utah Public Health Association (UPHA) guidelines, which help define local core competencies and scope of practice. State and national advocacy bodies like the National Association of Community Health Workers (NACHW) provide extensive resources on CHW integration, sustainable financing, and state-level policy tools.