Read the study:http://healthpolicyandreform.nejm.org/?p=13667
CHARLESTON, W.Va. -- At least 16 million low-income Americans will get new Medicaid cards through federal health-care reform between 2014 and 2019. More than 120,000 will be West Virginians.
Health reform skeptics predict that thousands of Americans will be wandering from doctor's office to doctor's office, Medicaid card in hand, looking for somebody who will take new patients. That might happen in some states, but it's not likely to happen in West Virginia, according to a study published in the January New England Journal of Medicine.
West Virginia is better prepared to provide newly insured citizens with primary care -- nonhospital care -- than 42 other states, according to "The States' Next Challenge -- Securing Primary Care for Expanded Medicaid Populations."
The researchers indexed the number of patients expected in each state to the supply of primary care doctors and health centers in each state, among other things. They estimated 139,000 new West Virginia Medicaid cardholders by 2019, the midpoint of the Kaiser Family Foundation range of 122,000 to 157,000.
Their top 10 "most-ready" list is filled with more prosperous states: Massachusetts, Vermont, Maine, New York, Rhode Island, Connecticut, Washington, Delaware, Hawaii.
Then there's West Virginia, in the No. 8 spot.
"I have to admit I was a little surprised when I saw West Virginia doing so well, because I think of it as a poor state, and these other states have comparatively well-funded health-care systems," said Leighton Ku, lead author and director of Health Policy Research at George Washington University.
West Virginia has definite minuses:
So why does West Virginia rank so high? Two things, Ku said:
"The large number of community health centers your state has is what really helps you, along with the fact that these centers are already seeing a lot of patients," he said.
One in five West Virginians -- 373,000 people -- get their primary care at one of the state's 28 community health centers, which provide care, regardless of income. About 90,000 of those patients are uninsured.
Second, West Virginia has a better supply per capita of primary care doctors, nurse practitioners and other health care professionals than most small states. "Most states have a very poor supply of primary care providers," Ku said. "In comparison, West Virginia has done well."
"West Virginia's ranking in this study is a testimony to a lot of hard work that's been done in this state on rural health care over the years," said Perry Bryant, director of West Virginians for Affordable Healthcare.
"Seventy percent of the people who will receive Medicaid cards are working families," he said, " We're not talking about lazy, undeserving people. They work jobs with no insurance, whether it be a fast-food restaurant, a hardware store or a small contractor."
People who earn less than 133 percent of the federal poverty level are eligible: $14,484 for an individual or $29,726 for a family of four.
Medicaid expansion will save West Virginia hundreds of millions each year, according to a 2009 actuarial study sponsored by the state Health Care Authority.
"The savings are going to be enormous," said Renate Pore, health-care analyst for the West Virginia Center on Budget and Policy.
"People who can't afford to go to the doctor often ignore warning signs till the problem blows up into a crisis and sends them to the emergency room," she said. "Once they start going to the doctor regularly, we'll see a huge drop in emergency room and hospitalization costs that get shifted onto paying patients. This will save individuals, insurance companies and government a lot of money."