Virginia lawmakers boosted Medicaid payments for primary care. Providers say it’s not enough.

The increase in funding is part of a larger conversation over how to improve services for...
The increase in funding is part of a larger conversation over how to improve services for low-income patients.(Getty Images & Virginia Mercury)
Published: Jul. 8, 2022 at 10:10 AM EDT
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Virginia’s latest budget includes an additional $82 million to boost Medicaid reimbursements for primary care providers, many still struggling to recover amid the uncertainty of the COVID-19 pandemic.

The move follows years of pushing from doctors, particularly pediatricians and other childhood practitioners, who represent the largest share of providers to participate in Virginia’s Medicaid program, according to Dr. Sandy Chung, a Northern Virginia-based pediatrician and president-elect of the American Academy of Pediatrics.

But the state’s low rates of repayment became particularly acute for many doctors over the last two years, as shutdown orders and general fear over the virus led to plummeting demand for medical services. Chung said she knew of at least one pediatric practice in Southwest Virginia that mostly served children covered under Medicaid and closed its doors during the pandemic.

“They just could not sustain their business, so they had to shut down,” she said. Several locations of her own practice also closed to new Medicaid patients after taking losses on the services they provided for them.

“Once more than 20 to 30 percent of your patient population is on Medicaid, it’s unsustainable,” Chung added. “So, it’s also creating access issues across the state.”

While increasing reimbursement rates has long been a goal for physician groups, the formation of a statewide task force on primary care in July 2020 jump-started the advocacy process, according to Beth Bortz, president and CEO of the Virginia Center for Health Innovation. Originally formed to meet some of the most pressing needs of the pandemic — including major shortages of personal protective equipment among primary care providers — the group gradually turned to long-term issues including reimbursement and payment models under Medicaid.

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NBC12 is a partner with The Virginia Mercury, an independent, nonprofit online news...
NBC12 is a partner with The Virginia Mercury, an independent, nonprofit online news organization covering state government and policy.(Virginia Mercury)

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