Abstract
Community Health Workers (CHWs) are gaining acceptance in the US health care system, but have been subject to challenges as to their "cost-effectiveness." This situation is shifting, with a growing body of published evidence as to the effectiveness of CHWs, but much of the evidence of cost savings from employing CHWs is still unpublished. Return on investment analysis for CHWs must consider a range of possible CHW roles and stakeholder points of view. Current trends suggest we may be entering a new era of acceptance in which a generally lower threshold of evidence is required in proposing the employment of CHWs.