Welcome to the Oklahoma Rise 25 and 25 RHTP podcast. In this episode we take a deep dive into the Community Health Worker (CHW) Expansion in Hospitals Initiative — a five-year, $10.8 million Rural Health Transformation Program investment designed to hire, train, and deploy 30 hospital-based CHWs across rural Oklahoma.

You hosts conferred with RHTP Task Force experts and policy strategists to unpack why this program is far more than a staffing grant: it is a proof-of-concept designed to generate auditable, payer-ready ROI that will enable long-term Medicaid and commercial reimbursement. We walk through the lead agency role of the Oklahoma Health Care Authority (OHCA), the uncompensated care fund reimbursement model ($69,000 per CHW per year), and the FY2026–FY2030 timeline and stage-based milestones.

Topics covered include the operational design (hospital and ED embedding, recruitment of local CHWs, rigorous training, and mandatory caseloads), the four core program components (recruiting and training, hiring and deployment, defined hospital settings, and monitoring/reporting), and the mandated service focus areas: behavioral health referrals, housing and social determinant screening, and nutrition/food security connections.

The episode explains the critical data and infrastructure dependencies — the Community Care Referral Platform, the consumer-facing monitoring tools, and the Building Health Data Utility (HIE) — and how CHWs act as the human agents who convert data alerts into real-world interventions. We highlight cross-pillar linkages with Clinical Integration Networks, community paramedicine, and chronic disease management programs that are essential for closing referral loops and validating outcomes.

Key performance targets and accountability requirements are discussed in detail: a 10% reduction in readmissions among multi-visit patients by years three to five, a phased utilization requirement (50% in years 1–2 rising to 100% in years 3–5), and mandatory, high-quality outcome tracking to support a State Plan Amendment (SPA) for Medicaid coverage. The episode draws on comparable evidence from Arkansas (significant Medicaid savings via HCBS diversion) and Texas (ED-based CHW reductions in ED visits) to model the expected ROI.

We also examine the major execution risks — hospital partner readiness and administrative capacity, CHW quality and training, reliable data collection and HIE interoperability, and proactive payer engagement — and the two immediate FY2026 priorities: OHCA’s rigorous selection of priority hospitals and activation of the uncompensated care fund to enable on-time recruitment and deployment.

Listeners will gain actionable insight into what hospital leaders, policymakers, and community stakeholders must do to translate $10.8 million into sustainable system change: treat the CHW not as a temporary hire but as the central node of an upstream prevention model, build the data pipeline to demonstrate auditable savings, and engage payers early to secure permanent reimbursement. This episode frames the CHW expansion as a potential turning point for rural Oklahoma’s financial and clinical stability — if execution matches the ambition.

Listeners are invited to join the Oklahoma Rise 25 in 25 RHTP Task Force at Rise25in25.org or email info@rise25in25.org for more information. The Oklahoma Rise 25 and 25 RHTP Forum is produced and directed by Dr. Keley John Booth, MD.