2022 Gage Award Winner | Harris Health System - Home Health Visits for High-Risk Diabetes Patients

Harris Health System, in Houston, serves a largely low-income patient population. Nearly 90 percent of patients are people of color. Among these communities, type 2 diabetes ranks among the most prevalent and costly outpatient diagnoses. To reach outside hospital walls and help high-risk patients manage their diabetes, the health system leveraged data to pilot a community health worker home visit program in 2017.