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The Community Foundation Blog


Nonprofit health care clinics prepare for Medicaid expansion
By KateGibson / December 27, 2018
Nonprofit health care clinics prepare for Medicaid expansion

As the New Year draws closer, Virginia’s community health care clinics are preparing for the state’s Medicaid expansion to take effect. Beginning January 1st, an estimated 400,000 low-income Virginians will be newly eligible for Medicaid. Until now, many of these individuals have relied on care provided by nonprofit clinics designed to serve uninsured patients who do not qualify for this federal benefit.

Most nonprofit clinics in Virginia, including the one operated by GoochlandCares, are preparing for the transition by helping newly eligible patients enroll in Medicaid and learn how to navigate the insurance system.

“Many of our patients have never had insurance,” said Sally Graham, Executive Director of GoochlandCares. “They have no idea how to do this. We want to make sure they have those navigation skills and continuity of care.”

GoochlandCares will continue its focus on serving the uninsured due to the continued demand for services among this population, as well as the cost of converting to a Medicaid-billing facility. In the short-term, they have trained additional volunteers and a new staff coordinator to coach patients through the enrollment process, and they are identifying local providers with the capacity to serve newly eligible patients.

 “We’re going to take the few months after January to see if our patients actually do have access to care. If they don’t, then we will regroup and decide whether we’re going to be a Medicaid biller,” Graham said.

On the flip side, CrossOver Healthcare Ministry has decided to jump in with both feet and become a Medicaid-billing facility so they can continue to serve existing patients now eligible for coverage. Of their 6,000 patients, about a third -- or 2,000 people -- will become eligible for Medicaid.

 “With such a large number of patients eligible for Medicaid, we did not feel confident they would have a place to go, or that they would feel comfortable going to another practice,” said Julie Bilodeau, CEO of CrossOver.

CrossOver was already equipped with the right kind of records system and employment infrastructure to make this transition happen, though the center will still need to take on credentialing costs, systems upgrades and additional staff positions. Bilodeau says this coverage expansion will connect many patients with affordable, quality health care coverage and additional benefits such as translation and transportation services.

Unlike enrollment through the federal Health Insurance Marketplace, Medicaid enrollment is open year-round. Now, Virginians who earn under 139% of the federal poverty level are eligible for coverage, regardless of disability status or employment status. For more information about Medicaid enrollment, visit www.coverva.org.

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