West Virginia Legislation Passes Landmark Healthcare Reform

June 01, 2009 - America's Agenda
By America's Agenda

SB 414, passed by the West Virginia legislature on May 28th, is the centerpiece of a group of landmark health reform bills passed by the West Virginia legislature this year. West Virginia's 2009 package of health care reforms launches the first stage of a 5-year plan that will extend affordable, high quality care to every West Virginia resident. By increasing coordination of care and reducing wasteful inefficiencies, full implementation of West Virginia's statewide "Roadmap to Health" reform plan is projected to reduce growth of health costs in the Mountain State by $2.7 billion by 2018.

This reform package is critically important to West Virginia, where health care spending is 13% more per person than the national average. West Virginia health costs continue to rise at a faster rate than the national average, eroding business profits and wage growth in a state where mean household income ranks among the bottom five in the nation.

Rising state health costs are associated, to a significant degree, with a growing incidence of expensive and life-threatening — but preventable — chronic disease conditions. Data from the U.S. Centers for Disease Control and Prevention (CDC) indicate that West Virginia has among the highest rates of childhood and adult obesity in the country. The state's high rates of obesity are associated with growing rates of diabetes, hypertension, hyperlipidemia, heart disease, pulmonary disorders and co-morbid depression.

"West Virginia is the nation's 'canary in the coal mine,' said America's Agenda president Doug Dority. "The same trends that are driving chronic disease and soaring health costs across the country are driving them in West Virginia. But conditions are worse in West Virginia than in many other parts of the country. People are more ill, and the cost of good health coverage is rising even faster than in other places."

"The reform plan enacted this year in West Virginia should be very encouraging for all Americans," Dority added. "If we can start to turn around the health care crisis in a state like West Virginia, there is no reason we cannot succeed in solving America's health care crisis."

Governor Joe Manchin III has indicated he will sign the SB 414 into law on June 17th. Key features of the new legislation include:

  • Creation (and funding) of a new Cabinet-level office with authority and responsibility for coordinating the state's health reform initiatives across all departments of state government.

  • Creation of four major patient-centered "medical home" pilots - The newly-created patient-centered medical homes will provide every enrolled participant with a personal medical team that consists of a primary care physician, nurses, pharmacists, and other health professionals. Under the physician's direction, the personal medical team will coordinate and support care for each patient through all stages of treatment. The four medical home pilots are designed as prototypes for a statewide medical home health care delivery system to be implemented within five years.

  • Access for the Uninsured - One of the four patient-centered medical home pilots will be a statewide project to provide high-quality medical services to the uninsured.

  • Streamlining costly and inefficient administration - West Virginia's Roadmap to Health plan targets elimination of wasteful duplication and inefficient administration that contribute to high health costs. The 2009 legislation begins administrative streamlining by enacting a single, centralized process of credentialing health providers. Under the current system, for example, physicians must be credentialed separately in each hospital and each health insurance network where they practice, incurring significant redundancy and waste of administrative resources. The 2009 legislation modernizes and simplifies the process.

  • Integrated HIT Plan - The West Virginia health reform plan is bolstered by an agreement with Governor Manchin's administration to channel adoption of health information technology (HIT) through a common, coordinating body, the West Virginia Health Information Network (WVHIN).

"This HIT agreement is important," says Dr. Ken Thorpe, who advised the Joint Legislative Committee on Health Care (Select Committee D) on developing West Virginia's health reform plan. "Our goals of improving quality, expanding access, and reducing the cost of health care can be achieved through a strategy that will use HIT combined with the adoption of community health teams and other care coordination models."

The 5-year statewide health care reform plan launched this year in West Virginia would not have been possible without the broad-based campaign that provided support to the reform process at every step. The West Virginians' Campaign for a Healthy Future brought together an unprecedented alliance of more than 50 state organizations representing labor, business, health providers, patient groups, community organizations, and the faith community. "We saw that the common ground that links most West Virginians is much wider than the differences between us," said West Virginia AFL-CIO president Kenny Perdue. "The bills we passed this year are just the start - but they're a good start."

"We've still got some hurdles to get over to guarantee access to affordable, high-quality health care for every West Virginian," agreed Campaign for a Healthy Future executive director George Manahan. "But we've built a robust campaign with the capacity to bring support behind elected office holders who are leading the way. The campaign organization we've build to get the reform process started is going to drive transformation of our health care system over the finish line."

"America's Agenda is honored to work with so many inspiring citizens leaders in building the West Virginians' Campaign for a Healthy Future," said America's Agenda executive director Mark Blum.

"The health care reform plan launched this year in West Virginia is not an isolated event," he added. "It parallels in many ways the reform plan enacted in Vermont, with our support, in 2006. West Virginia's 5-year 'Road Map to Health' reflects many of the key design features being considered in Congress, right now, and articulated by President Obama. West Virginia, by sheer political will, is preparing itself to be full partner with the federal government in implementing a national healthcare reform plan that will be enacted this year."

To learn more about America's Agenda: Health Care for All go to: www.americasagenda.org

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