Listen now (20 mins) | Listen Now The use of community health workers (CHW) dates back to the 1800s. The impetus for these workers today is to provide peer support largely in poor or under-served communities since these communities typically suffer disparities in health care access, in the quality of health care delivery and consequently experience higher morbidity and mortality rates. The ACA via the Center for Medicare and Medicaid Innovation is supporting CHW demonstration projects, states are testing their use via Medicaid programming and various providers are using CHW to improve self management support among high health care service utilizers.