Empowering community health workers: Our investment in Pear Suite

Community Health Workers (CHWs) play an increasingly critical role in the U.S. healthcare delivery system. CHWs are public health workers who are trusted members of and/or have an unusually close understanding of the community served. They provide a wide range of services, ranging from health promotion and education to care coordination and social support.

There is a growing body of evidence that CHW interventions have a significant positive impact on health outcomes and costs. These reductions translate into meaningful cost savings for healthcare payers, and Medicaid plans are increasingly demonstrating the impact of these care models. For example, The Arkansas Community Connector Program, a pilot program run under the state’s Medicaid 1115 waiver, resulted in a 23.8% lower average annual Medicaid spending per participant over three years.

Today, the CHW profession is highly fragmented and lacks standardization. Training and certification requirements vary by state and by organization. And CHWs are typically employed or volunteer across a variety of settings from FQHCs to community based organizations (CBOs), which represent the largest employer of CHWs with 37% of the workforce.

Momentum is building for community health workers to drive greater impact in healthcare:

  • Workforce development: The total number of CHWs is expected to grow rapidly, in part due to federal investments in workforce development. The Biden administration awarded $225 million in American Rescue Plan funding to train over 13,000 CHWs in 2022. Additionally, The Consolidated Appropriations Act of 2023 authorized $50 million annually to build CHW workforce capacity across 2023-2027.
  • Medicaid reimbursement: Coverage for CHW services is accelerating. Before the pandemic, few states reimbursed CHWs through Medicaid. As of 2022, 29 states allow Medicaid payments for CHW services, up from 21 in 2021.

The upshot is that there is a growing CHW workforce with access to Medicaid reimbursement dollars—yet most CHWs and the CBOs that employ them have no experience submitting healthcare claims. CHWs and CBOs lack the infrastructure to document their services and manage the healthcare revenue cycle. Since CBOs are often grant-funded, a new stream of Medicaid fee-for-service reimbursement for services they already deliver represents an attractive source of financial stability. Health plans have already demonstrated strong intent to further integrate CHWs into care delivery models, representing a large market opportunity for innovators in this space.

Our investment in Pear Suite

Pear Suite is addressing this opportunity through its care navigation platform that empowers community health workers to address the social drivers of health. The company’s SaaS platform enables the rapidly growing CHW workforce to standardize the data they collect, improve care navigation, and access reimbursement from the increasing number of health plans that cover CHW services.

Pear Suite is led by a team with unusually strong founder-market fit. Selling into the community health worker market requires a high degree of trust from all stakeholders. Colby Takeda, Pear Suite’s Co-Founder and CEO, spent the past decade working in and around community based organizations including the Hawaii Meth Project and the Blue Zones Project by Sharecare.

Today Rock Health Capital is announcing our most recent investment in Pear Suite, alongside Flare Capital Partners, AARP, and California Health Care Foundation. We couldn’t be more excited to partner with the entire Pear Suite team!

Learn more about how Pear Suite is helping CHWs and payers drive better outcomes, or schedule a demo with the team here.

Rock Health Capital is an early-stage venture fund focused on digital health. We would love to hear from you. Get in touch!