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Rural care to get big shot in arm from health bill

CHARLESTON, W.Va. -- As a rural state, West Virginia will receive a major influx of dollars for preventative medical care under the new national health reform law, state primary care experts said Monday. 

"This will prevent a lot of unnecessary hospital and emergency room bills," said Louise Reese, director of the West Virginia Primary Care Association.

An estimated 169,000 West Virginians get no regular primary care, she said, either because they cannot afford doctor visits or can't find affordable care in their communities.

West Virginia leads the nation in diabetes, heart attacks and angina, according to the state Bureau of Public Health. The state is second in strokes and certain forms of cancer.

"We are gearing up to expand affordable preventative care in underserved areas of the state," Reese said.

The new law:

 

  • Provides $11 billion nationwide, beginning in 2011, for expansion of low-cost community health center care;
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  • Provides $1.5 billion to expand the number of doctors who can work off their student loans by practicing in underserved rural area. Most of West Virginia qualifies;
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  • Provides subsidies for insurance premiums for people who cannot otherwise afford insurance, beginning in 2014;
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  • Increases funding for medical school residencies in rural areas;
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  • Increases reimbursement to doctors who take care of Medicaid patients, starting in 2014;
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  • Provides free wellness screenings for West Virginia's 372,000 Medicare recipients, starting in 2010;
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  • Allows adults who make less than 133 percent of poverty to apply for Medicaid, beginning in 2014.
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    "The people who don't get care now tend to be younger working families who don't make much money," said Craig Robinson, CEO of Cabin Creek Health Systems. "Or they have inadequate health plans with huge deductibles and big co-payments."

    "When people end up with hospital bills they can't pay, everyone else pays for it," said Perry Bryant, director of West Virginians for Affordable Health Care. Hospitals shift part of unpaid bills onto the bills of insured patients, "and that adds about $1,000 to the average yearly insurance premium, according to insurance industry figures," he said.

    "This will save a lot of human suffering while it saves us all money," said Martha Cook Carter, CEO of FamilyCare, which provides sliding-scale care to 23,000 people in Kanawha, Putnam and Boone counties. "The major parts of the law don't kick in till 2014, which gives us a chance to get ready."

    In 2009, Charleston Area Medical Center wrote off $18 million in charity care and $20 million in bad debt, spokesman Dale Witte said. CAMC absorbs between 20 and 25 percent of West Virginia's uncompensated care, he said.

    "We do look forward to everyone being insured and having some kind of health care coverage," Witt said.

    "It's a very complex law, so we're waiting to see how the whole package shakes out. A lot could happen between now and 2014."

    Reese said she was stunned to hear House members suggest during debate that health reform funding might be used for abortions at community health centers.

    "There have never been abortions performed at community health centers," she said. "But there is a lot of prenatal care and well-baby care.

    "The stimulus funding is helping us gear up," Reese said. "Electronic health records and broadband will help the system handle the new patients. Many centers are adding patient rooms and parking."

    With the new electronic tools and funding, "We will aggressively step up public education programs to help people learn to take better care of themselves," Robinson said.

    Robinson has worked in West Virginia healthcare since the 1950s, he said. "If you go back to the 1960s when Medicare was approved, there were also dire warnings that Medicare and community health centers were going to bring on disaster. Now, both have broad bipartisan support.

    "Ten years from now, will the same be true for this law? We'll see. Meanwhile, a lot of people will get health care who otherwise would not."

    Reach Kate Long at katelong@wvgazette.com or 304-348-1798.


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