Pear Suite Community Health Worker Network Expands

Pear Suite, a digital health company empowering community health workers (CHWs) to address the social determinants of health, is building a growing provider network in partnership with health plans.

Over the past ten months, Pear Suite has partnered with seven health plans to recruit and onboard more than 1,000 CHW providers from over 200 community-based organizations, expanding capacity to serve more than 11 million Medicaid lives across three states. Simultaneously, Pear Suite has contracted with eight additional Medicaid and Dual Eligible Special Needs Plan (D-SNP) plans to deploy CHW providers in communities where they are needed most.

Pear Suite says its AI-powered platform continues to evolve, providing significantly greater value to CHWs, doulas, and other frontline health workers, many of whom are transitioning from paper assessments and spreadsheets. Pear Suite currently supports organizations across 25 states, with rapid expansion planned for 2025.

In a 2024 interview with Healthcare Innovation, Colby Takeda, co-founder and CEO of Pear Suite, said his organization is helping CHWs, promotores, health representatives, doulas and others assess and address social drivers of health. In California and other states with Medicaid-sponsored CHW benefits in place, Pear Suite has also supported CBOs in billing managed care organizations for qualifying CHW services. 

As the software solution was being created, state agencies were starting to roll out CHW reimbursement for Medicaid. “That was good timing for us, because the Medicaid reimbursement itself had data-tracking requirements and had compliance and audit requirements,” Takeda said. “You have to be able to submit claims that based on Z codes. So we actually built support for all those tools, and now support community-based organizations in their billing,” he added. “For many of these groups, going from nothing to now getting paid for their work has been huge.”

Pear Suite is looking to help CBOs with other data-sharing use cases. Initially the health plans are the ones that are the managers and facilitators of the CHW benefit, Takeda explained. Of course, they want to tie this benefit to their care gap closures in their population health initiatives. “We're now doing some sharing of that kind of data between health plans and community-based organizations,” he said. “The next step after that is to get data from the health system so that we know who gets discharged from a hospital or an ER or has specific kinds of treatments they have to get connected to.”

One Hawaii-based nonprofit organization that has become a Pear Suite user is Na Hoaloha on the island of Maui, whose work connecting people to local resources became even more crucial after the devastating August 2023 Lahaina fire. 

“We've been involved with Pear Suite for about four years now. Right after the pandemic began, they were very instrumental in gathering all the healthcare providers and nonprofits in Hawaii to focus on food insecurity,” said King Van Nostrand, the organization’s executive director. “We live on a valley island and a beautiful place that has lots of farmers and lots of crops, and we needed to get those crops to the people. They really focused on providing security for food during the pandemic, and we've just been growing with them ever since.”

Na Hoaloha’s work become even more challenging after the Lahaina fire. “Our work became dramatically dysfunctional after the fire,” Van Nostrand said. “We still took care of over 137 participants who were in the fire zone who had to be relocated. They had to readjust with absolutely nothing in their hands or pockets.”

“Our people are very much more isolated,” said Kathleen Kenney, Na Hoaloha’s navigator, who helps connect people with the care they need. “They’ve lost their natural support system and their friends. I had one person tell me he doesn't know where any of his friends are. It's been over a year, so those things are really heartbreaking and really impacting people's mental health and just their health in general.”

Instead of having a folder with a stack of papers on her desk, Kenney now has a system to track every meeting and referral about each client. “Anyone that I meet with, I do a baseline survey, and all of that gets documented into Pear Suite, and then there's a two-week follow-up, a quarterly assessment and a six-month assessment,” she said. “All of that then generates data, which shows, hopefully, the positive impact that a navigator or community health worker has on improving the lives of people living independently, and that helps demonstrate the need for the position and future funding, of course.”

“Kathleen has made a huge difference in our business,” Van Nostrand said, “because we're present. We're not just behind a wall or behind a door or a phone. We're out there in the community and finding out exactly what we need to know to help try to solve someone’s problems. Our business is changing on a weekly basis, and we need to have support and tools that are easily adjustable, that are fluid, and that can grow with the times. And we find that by working with Colby and the Pear Suite community, we have that flexibility.”

The company said that members of the Pear Cares Provider Network also benefit from clinical, operational, and administrative support, including care plan reviews, claims management, policy training, and compliance assistance—key areas that often present significant challenges for community-based organizations. 

Health plans are also benefiting from the Pear Suite software, as they are eager to simplify the credentialing, contracting, compliance, and reporting process for CHWs, while elevating their skills and experiences, the company said. The network also offers comprehensive educational resources, regular training opportunities, and a robust community to share best practices and collaborate.

“The ultimate goal of the Pear Cares Provider Network is to increase utilization of preventative CHW services while breaking down legacy barriers that have limited CHWs from partnering with health plans,” added Takeda in a statement. “By doing so, individuals with unmet health and social needs can truly benefit from the knowledge, skills, and lived experience of CHWs, an underutilized workforce that has proven to be exceptional at closing care gaps in a culturally sensitive, person-centered way.”

As one of Pear Suite’s earliest partners, California’s Health Net, a Medi-Cal managed care organization and a Centene subsidiary, has partnered with Pear Suite to recruit and onboard over 300 CHWs to support their statewide membership of 1.6 million.

"Community health workers play a vital role in bridging the gap between healthcare systems and our members, helping ensure they receive services related to perinatal care, preventive care, transportation, oral health, aging and much more," said Dorothy Seleski, senior vice president for Medi-Cal at Health Net, in a statement. "Through our partnerships, we're able to empower members to take charge of their health, ultimately leading to improved health outcomes and reduced disparities.”

As the Pear Cares Provider Network expands, Pear Suite said it would continue forging new partnerships with a diverse range of health plans across all business lines, including Medicaid, Medicare, and commercial insurance.