An Analysis of Community-Based Health Workforce Training Efficacy: Evidence From the Affordable Care Act Insurance Navigators in Illinois

Abstract

Objectives. A community-based training with core competencies in health insurance, health care resources, and outreach for over 1,700 Affordable Care Act navigators in Illinois from 2013 to 2014 was designed, delivered, and evaluated by an academic–community partnership with expertise in health care, social services, health policy, and community outreach. Methods. Pre- and posttraining scores on a knowledge-based certification exam were linked to navigators’ baseline sociodemographic characteristic. Additionally, self-reported training evaluation and posttraining support were summarized from an online follow-up survey of the workforce. Results. Although the material was initially unfamiliar and the population heterogeneous, the training program brought all identified subgroups from a below passing mean score (71%) on the pretest up to above proficiency (80%) in a posttest assessment—suggesting a highly accessible training program across navigator sociodemographic groups. Navigators reported additional training on Medicaid and marketplace structure and eligibility to be very important. Conclusions. Supplementing or replacing diminishing federal funding for consumer outreach workforce training and support at the state or community level was found to be an important priority that can increase competencies in a diverse population. Findings also indicated that the inclusion of ongoing wrap-around resources remain in high demand among navigators in the complex, ever-changing health care landscape in the United States.