Community-based organizations (CBOs) sit at the center of one of the biggest reimbursement opportunities in recent memory. Under CalAIM and Medicaid, the community-centered, culturally responsive care that CBOs have always delivered — food delivery, in-home support, transportation, family services, and the work of community health workers (CHWs) who help clients get to appointments and navigate insurance — is now billable.

The opportunity is real, but so is the gap. Many mission-driven organizations still lack the billing and documentation infrastructure to capture revenue for services their teams are already providing. Before closing that gap, an organization needs an honest answer to a simpler question: how ready are we? That’s what Pear Suite set out to measure.

Building a Readiness Assessment: Our Methodology

Pear Suite developed a 40-question assessment for CBOs delivering reimbursable care management services, organized into four domains of 10 questions each: workforce capacity, technology infrastructure, operational workflows, and organizational foundations. Together, these domains give an organization a comprehensive view of its capacity and infrastructure, and help pinpoint exactly where the gaps are.

To understand what readiness actually predicts, Pear Suite partnered with BluePath Health to evaluate the results. Thirty-three organizations completed the assessment, and 12 follow-up interviews added qualitative depth. Respondents ranged from volunteer-run operations with fewer than four staff tracking clients on spreadsheets, to larger CBOs with 14–24 employees already running case management software. Of the 33 organizations, 18 were using a case management platform, and 15 of those had implemented Pear Suite specifically.

A Clear and Consistent Divide

The findings were unambiguous: CBOs using a case management platform scored meaningfully higher across every one of the four readiness domains. Organizations implementing Pear Suite were 2–3 times more ready to manage eligibility, claims, and payment tracking, and to securely exchange data with partners, than organizations without one.

Breaking that down further:

• Billing readiness: Platform users were 2.8 times more ready to manage eligibility checking, claims submission, and payment tracking.
• Documentation compliance: Platform users were nearly twice as ready to capture and standardize the data required for billing and audits.
• Interoperability: Platform users were 2.3 times more ready to securely share data with external partners — increasingly a requirement from health plans.

One finding stands out for what it implies about equity between organizations of different sizes. Among CBOs without a platform, staff headcount tracked closely with readiness; in other words, bigger teams meant more readiness. Among Pear Suite users, that relationship disappeared entirely. What that tells us is technology appears to level the playing field for smaller organizations that can’t compete on headcount alone. Platform users outperformed non-users across every size tier except the very largest, where the gap narrowed and slightly reversed — suggesting that at real scale, size can substitute for some of what a platform provides, but not for most CBOs.

Real Barriers and Real Demand

The interviews surfaced why so many CBOs still operate without this infrastructure: funding constraints, confusion around CalAIM and CHW billing rules, the difficulty of formalizing volunteers into paid provider roles, thin leadership bandwidth, and a lack of training resources. These are structural problems, not motivational ones — CBOs want this support, as evidenced by 100+ attendees at a March 2026 readiness webinar co-hosted by the California Association of Community Health Workers (CACHW), Pear Suite, and BluePath Health.

The cost of going it alone shows up in the interviews, too. One small CBO managing its own billing reported reimbursement cycles of 4–6 months, long enough to stall hiring and raise questions about the organization’s viability. Organizations billing as subcontractors under Pear Suite’s infrastructure reported more streamlined reimbursement by comparison.

What This Means for Your Organization

Readiness isn’t a single yes-or-no threshold. It’s a multi-faceted snapshot of where an organization stands right now. The path ahead is straightforward:

1. Take the readiness assessment before evaluating any platform, and share the results with your team.
2. Prioritize technology infrastructure and operational workflows, the two domains with the highest leverage on reimbursement readiness.
3. Use available resources, including the Pear Suite Resource Library, to close the specific gaps the assessment surfaces.
4. Reassess every 6–12 months, since readiness changes as your organization and its programs grow.

The Bottom Line

CHWs and care management teams show up because of mission, not margins. But mission alone doesn’t keep the lights on. Understanding readiness is what lets a CBO convert its lived expertise and community trust into compliant, reimbursable, sustainable care. Organizations still on manual processes don’t need to overhaul everything at once; they need to know where they stand, then act on the highest-leverage gaps first.

Take Pear Suite’s CBO Readiness Assessment

Based on findings from Pear Suite’s readiness assessment evaluation, conducted with BluePath Health across 33 community-based organizations and 12 follow-up interviews, with support from the California Health Care Foundation (CHCF) and its CHCF Health Innovation Fund.