EXPANDING HEALTH CARE ACCESS

Increasing health care access and quality, ensuring mental health and addiction treatment

I have been thankful to see so many of my patients now have access to health care with Virginia’s expansion of Medicaid. As a doctor, I have thought a lot about health care in our region. These are some of the ideas to increase access to quality health care in SWVA.

Increasing Patient Choice. Southwest Virginians need access to quality health care. We also need choice. Research has shown us that health care monopolies increase costs for patients, and also affect quality of care. We need to make sure our citizens do not have to drive hours to obtain emergency health services, or pay higher and higher prices for lower quality treatment- even when they have insurance. We need to push for price transparency in health care and publicly report and rank our health systems on quality and cost including percentage of administrative/wasted costs.

We need to dramatically improve health care quality in the area by supporting health development zones and pilot innovative projects in the SWVA region, including support for Medicaid/Medicare value-based health care initiatives. We need to get our citizens access to standards of care, including setting up our own telemedicine Centers of Excellence so our citizens can access top quality evidence-based specialty care all across the country.

We also need to be creative about attracting new providers to the area through scholarship and loan forgiveness programs, and also support independent practitioners and health systems in the area.

Black Lung. We must support our miners to receive black lung benefits, and ensure patients with black lung receive adequate specialty care. We must support research in advanced black lung and access to the latest treatment options.

Expanding Substance Use Treatment. I have been providing addiction treatment in Dickenson County for over a year. Our counties have high rates of opioid addiction and overdoses per capita, yet there are few providers offering addiction treatment. We have to get rid of the stigma, and ensure our neighbors, family, and friends get the help they need. Virginia has been at the forefront of ensuring Medicaid provides coverage for opioid treatment.

We need to further expand medication-assisted treatment (MAT) for opioid addiction and expand harm reduction policies. Learning from other states, we can create hub-and-spoke models that create a cohesive ecosystem for addiction treatment, increasing MAT access in primary care with referrals to these specialty addiction centers. We need to increase the number of step-down and intensive outpatient programs that offer residents concentrated treatment outside of our limited number of detox/rehab centers.

Like other states, we need to support challenges and fund innovative programs that are creating next generation opioid treatments, including digital therapies and rehab at home programs. We also need to digitally map our current MAT providers, and make it easily accessible to patients.

Increase Access to Mental Health Treatment. SWVA is in dire need of adequate mental health treatment. Patients with severe mental health issues have difficulty seeing a psychiatrist and getting appropriate treatment. We need to attract more psychiatrists to the area, ensure area psychiatrists and behavioral health practitioners receive adequate insurance reimbursement so they see our patients with Medicaid, and increase support to our community behavioral health centers. We need to expand psychiatric step-down programs, increase the quality of our inpatient psychiatric facilities, and overall push to innovate in psychiatric care and behavioral health in Virginia, bringing it into the the 21st century. We need to work on the stigma surrounding mental health diagnoses, and ensure our local and state policies treat mental health patients compassionately- like they treat all other patients and citizens in the area.