Why Everyone Is Talking About CHW Medicaid Billing (And How It Secures Community Health Worker Jobs in Virginia)

At the Virginia Community Health Worker Association (VACHWA), our mission is clear: we aim to support, connect, and empower Community Health Workers (CHWs) across the Commonwealth. We are a unified collective, working tirelessly to ensure that every CHW in Virginia is recognized as a vital professional in the healthcare landscape. Today, there is a massive shift happening in our field, one that is moving us from the sidelines of “grant-funded projects” to the center of sustainable healthcare.

We are talking about Medicaid billing.

If you have been in the CHW world for a while, you know that the “G-word”, Grants, has dominated our lives. While grants have funded amazing work, they are often temporary. They start, they flourish, and then they end, leaving CHWs wondering where their next paycheck will come from. But the tides are turning. Medicaid reimbursement is the key to unlocking long-term job security, professional respect, and expanded health equity for all Virginians.

The Big Shift: From Grants to Sustainability

For nearly 80 years, CHW programs across the United States have relied on a patchwork of short-term grants. It was a cycle of starting over, reapplying, and hoping for the best. But between 2016 and 2020, something incredible happened: the number of CHWs billing Medicaid increased by a staggering 638%. In that same period, the total volume of CHW services grew nearly 23-fold.

What does this mean for us in Virginia? It means the world is finally catching on to what we’ve always known: CHWs are not just “nice to have.” We are essential.

By moving toward a Medicaid reimbursement model, we are shifting the foundation of our profession. Instead of waiting for a one-time grant to fund a specific outreach project, healthcare providers, including community health centers, health departments, and local health systems, can now see a clear path to funding permanent CHW positions. Medicaid billing provides a steady, ongoing revenue stream that makes hiring a CHW a smart, sustainable business decision for any healthcare organization.

How Medicaid Billing Empowers Your Career

When we talk about Medicaid billing, we aren’t just talking about paperwork and codes. We are talking about your career. We are talking about your ability to stay in the community you love, doing the work you were born to do, without the constant fear of a grant expiring.

Here is how this transition secures CHW jobs in Virginia:

1. Permanent Positions: When an employer can bill for the services you provide, whether that is patient education, health integration, or social support, your role becomes part of the permanent budget. You are no longer a “line item” in a temporary project; you are a core member of the healthcare team.
2. Professional Legitimacy: Federal recognition is growing. In 2024, Medicare introduced its first billing codes for CHW services. This legitimizes our work at the highest levels of government. When Medicare and Medicaid recognize the value of a CHW, every other insurance provider and healthcare system takes notice.
3. Career Ladders: Sustainable funding allows for growth. With permanent roles come opportunities for senior CHW positions, supervisory roles, and specialized training pathways. We are moving from a “job” to a “career.”

At VACHWA, we advocate for these changes because we believe in the power of our members. You can learn more about our commitment to your professional growth on our About Page.

Bridging the Gap: Health Equity and Medicaid

We know that health equity isn’t just a buzzword; it’s our daily reality. CHWs are the bridge between clinical care and the community. We are the ones who understand why a neighbor can’t make it to their appointment or why a family is struggling to access fresh food.

Medicaid billing is a powerful tool for health equity because it prioritizes the populations that need support the most. In Virginia, Medicaid covers a significant portion of our most vulnerable residents. When we create a system where CHWs can be reimbursed for serving these populations, we ensure that resources are directed exactly where they can do the most good.

By billing for services like community health integration and social determinants of health (SDOH) screenings, we are proving the ROI (Return on Investment) of health equity. We are showing that when a CHW helps a patient manage their diabetes or navigate a housing crisis, it saves the healthcare system money by preventing expensive ER visits and hospital stays.

What This Means for Virginia’s CHW Workforce

The landscape in Virginia is evolving quickly. As more states adopt clear billing policies and procedure codes, reimbursement rates are becoming more standardized. Across the country, these rates can range from $2.79 to $35 per half-hour of service, depending on the complexity and state guidelines.

This financial viability allows Virginia employers to:

• Invest in Training: Employers are more likely to pay for your certification and continuing education if they know your role is financially sustainable.
• Expand Outreach Teams: Instead of one CHW covering three counties, sustainable funding allows for larger, more effective teams.
• Unite Clinical and Community Care: Billing codes create a common language between CHWs and doctors, fostering a collaborative environment where our expertise is respected.

We are here to help you navigate these changes. If you have questions about how these shifts affect your specific role or your organization, please Contact Us. We are stronger when we share our knowledge and advocate together.

Preparing for the Future: Your Role in the Mission

As we move toward this new era of Medicaid billing, professional development is more important than ever. To be eligible for many of these reimbursement models, certification and standardized training are key. This is why VACHWA focuses so heavily on providing you with the tools, workshops, and guides you need to succeed.

We encourage every CHW in Virginia to:

• Get Certified: Certification is the “gold standard” that many billing models require.
• Stay Informed: Follow the updates from the Virginia Department of Medical Assistance Services (DMAS) and stay active in the VACHWA community.
• Advocate: Use your voice to tell your story. Your data and your success stories are the evidence policymakers need to keep expanding Medicaid billing.

Supporting, Connecting, and Empowering

We are at a turning point in the history of our profession. The shift toward Medicaid billing is a sign that the world is finally recognizing the vital role CHWs play in achieving health equity. It is a transition that promises more stability, more respect, and more opportunities for every Community Health Worker in the Commonwealth.

At the Virginia Community Health Worker Association, we will continue to advocate, educate, and unite. We are committed to ensuring that these changes benefit the workers on the ground: the ones doing the hard work of building a healthier Virginia every single day.

Let’s embrace this change together. Let’s move forward with confidence, knowing that our work is valued, our jobs are securing, and our mission is more important than ever.

Our Mission Summary:
The Virginia Community Health Worker Association (VACHWA) exists to support, connect, and empower the CHW workforce. We advocate for the professional recognition and sustainable funding necessary to achieve health equity and improve the well-being of all Virginians.

Are you ready to take the next step in your professional journey? Join us at chwofva.com and become part of the movement that is transforming healthcare in Virginia. Together, we are the heart of community health!