VCU news

By Pamela DiSalvo Lepley

WILLIAMSBURG, Va. – Virginia’s uninsured – most of whom are employed – rely on fragile safety net systems for their health care, according to Dr. Sheldon Retchin, Virginia Commonwealth University Health System senior executive vice president and chief operating officer.

These systems are neither financially secure, nor uniformly available for the uninsured, Retchin said speaking at the First annual Governor’s Conference on Covering the Uninsured in Williamsburg.  Retchin described the interrelationships of safety net systems and the needs of the uninsured as “the ecology of safety net care.”  He said that less access to preventive, acute and chronic care for the uninsured leads to higher instances of illness, disease and death.

“The struggle to provide quality health care to the uninsured goes on every day in Virginia and across the country,” Retchin said.  “It is increasingly difficult for safety net health systems to cover their costs because of the growth in managed care plans, changes in reimbursement from government-sponsored programs and increasing competition for ‘paying’ patients.”  He said that nearly half of safety net hospitals in the country function with operating losses.

“The survival of safety net health systems and their mission to deliver quality health care to the uninsured depends on forging new and stronger relationships with community programs and better coordination and management of health care services,” Retchin said.

Virginia’s two academic health centers, Virginia Commonwealth University and the University of Virginia, offer comprehensive preventive, acute and chronic health care to a significant proportion of the uninsured care in the state, according to Retchin.  Furthermore, he noted that dozens of community agencies, community health care centers, providers and facilities contribute to the safety net patchwork for vulnerable populations in Virginia.

Retchin described some of the strategies employed by the VCU Health System to align its funding with the unmet needs of its uninsured patients:

·         The Virginia coordinated Care for the Uninsured – a joint effort with the VCU Health System, the City of Richmond and community primary-care physicians to provide low-income patients with access to physician and hospital services, primarily for preventive care.

·         Jenkins Care Coordination Program – Partnership of the VCU Health System and the Richmond City Department of Public Health to coordinate medical services for underinsured and uninsured Richmond residents.

·         Founding member of Richmond Enhancing Access to Community Healthcare (REACH), which was awarded a Community Access Program grant to help uninsured families find quality healthcare in Richmond.

·         Cancer Outreach Programs, such as the VCU Massey Cancer Center’s rural cancer outreach program, which takes cancer treatment and care to Virginia’s rural areas.

Retchin cited the efforts of the Governor’s Indigent Care Task Force, which is charged to modify the current funding sources to align with the needs of the uninsured and to identify alternative sources of funding for the delivery of indigent care at the state’s two academic health centers, VCU and UVA.