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Practice and Power: Community Health Workers and the Promise of Moving Health Care Upstream

Manchanda, Rishi MD, MPH

Journal of Ambulatory Care Management: July/September 2015 - Volume 38 - Issue 3 - p 219–224
doi: 10.1097/JAC.0000000000000098

Against the backdrop of historic upheavals in American health care, a resurgent interest in the role of community health workers (CHWs) presents important strategic and technical questions. The ability to successfully navigate these issues and expand the health care role and impact of CHWs will depend on how stakeholders reimagine elements of practice and structures of power in American medicine. Practice redesign and redefined power dynamics can help health care settings successfully integrate CHWs, address social determinants of health for patients and communities, and achieve the Triple Aim of improved outcomes, higher quality of care, and lower costs.

HealthBegins & Veterans Health Administration Greater Los Angeles Healthcare System.

Correspondence: Rishi Manchanda, MD, MPH, HealthBegins, 4162 Farmdale Ave, Studio City, CA 91604 (

Conflicts of Interest and Source of Funding: Dr Manchanda has received honoraria and consulting fees from HealthBegins, which has received grants from The California Endowment and The Commonwealth Fund. He has received royalties from TED Books and speaking fees through the Premiere Speaker's Bureau and All American Entertainment Speaker's Bureau. He is a part-time employee of the VA Greater Los Angeles Healthcare System.

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