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Health Net Uses Volunteer Network of "Promotores" to Address Equity in Rural Health

Date: 06/26/19

Health Net Uses Volunteer Network of "Promotores" to Address Equity in Rural Health

In rural Madera County, California, the largely Latino population suffers from many health challenges common to much of rural America. Residents have difficulty navigating the health care system and they're in need of community and social services to address critical social determinants of health. Those determinants include food insecurity, transportation issues and connecting with local school districts. Residents of this rural region of California are also underserved, due to a shortage of providers and culturally- and linguistically-appropriate services.

Health Net, a subsidiary of Centene Corporation, is addressing these challenges head-on. Through their Promotores Health Network, the company is transforming the larger Madera community one person at a time. Working in close partnership with members of the community, Health Net is taking a whole health approach to assisting at-risk individuals. "Promotores de Salud" (Health Promoters) are local residents trained by Health Net who volunteer their time to help other locals navigate the healthcare system. The Promotores network has used a grassroots strategy as the main pillar of its system navigator model to boost access local resources and deliver culturally relevant education.

Health Net trains Promotores de Salud in a variety of health topics relevant to their communities, including what local services and resources are available for those in need. They also participate in community activities and engage local residents, with the goal of informally learning about the health needs and priorities of the communities. In addition to actively listening to residents for emerging local issues, Promotores also engage with Health Net specialists to learn about the latest, broad trends in the healthcare industry trends

Health Net supports their Promotores by analyzing HEDIS and other data to find where the biggest opportunities lie, and to identify members who could benefit most from the program. The Promotores then serve as the necessary link to the community, helping with education, referrals, and care navigation. Madera County, for example, has a large migrant population whose needs include culturally relevant education on asthma, diabetes, women’s health issues, health screenings and healthy diet.

The program was originally created as part of the U.S.-Mexico Binational Health Exchange, which gave both countries the opportunity to learn about how health care is delivered in their neighbor country. These experiences informed the creation of the Promotores program. Health Net designed it by adopting the best practices of similar programs in Latin American countries, from which many Madera County residents have roots. As such, community leaders acting as Promotores were able to build trust with members and expand the scope of the program to include more than what the plan could provide without the Promotores. Data collected by Health Net support this "trust" factor as well, with the company seeing significantly higher participation in education programs hosted with the Promotores than those without.

Member satisfaction and engagement with the program are both high – indicating success at this early stage. One challenges has been collecting the information needed to evaluate long-term outcomes and scalability. Additionally, there is no state funding available to support such programs, though Health Net and other Medi-Cal payers support creating standards for training Promotores and others engaged in similar work.

Currently, there are 56 active Promotores that participate in meetings and coalitions on behalf of Health Net. That includes 17 "core" members who the company actively deploys to key communities and neighborhoods.  The Promotores program is also active in East Los Angeles, where a similar model of health promotion and education is delivered to urban populations.

Last Updated: 07/13/2020