The Health Care System in West Virginia

West Virginia has successfully implemented Medicaid expansion and Obamacare, but its residents still face some health challenges. Factors like public health funding, socioeconomic indicators, legislative positions and disease management, play a role in the state’s level of health. West Virginia and the federal government run a partnership exchange. The state uses as the portal for residents to choose healthcare plans.

West Virginia has taken a proactive approach to the expansion of Medicaid and used an auto-enrollment process to determine individuals’ eligibility, by cross-referencing lists of people who are using other state benefit programs. As of the 22nd of February 2015, the number of residents who were enrolled in qualified health plans via the exchange, was 33, 421. According to HHS, 86% of them had obtained premium subsidies.

The use of federal funds to increase Medicaid eligibility to 138% of poverty, played a major role in the success of Obamacare in West Virginia. It was estimated that 53% of West Virginia’s uninsured population would be eligible for expanded CHIP or Medicaid, and another 23% would qualify for tax credit subsidies to buy their own coverage in the exchange. Medicaid enrollment continues throughout the year, so it is expected that the number of residents enrolling will only continue to increase. This will reduce the uninsured rate in the state.

West Virginia is also one of the states with the highest proportion of Medicare beneficiaries. The state has a high percentage of residents who are eligible for Medicare, because of disability. Medicare spending in the state is around $9,332 yearly per enrollee. $3.5 billion is spent every year.

Residents can enroll Medicare Advantage plans, as these plans provide extra benefits. In 2014 alone, 24% of West Virginia Medicare recipients chose a Medicare Advantage plan. Around 51% enrolled in Medicare Part D to get prescription drug benefits.

The Problems with Health Care

These past few years, people have seen an improvement in healthcare with health technologies emerging. There has been an industry boom, in terms of digital and mobile health technologies, marking the great improvements to the overall state of American health care. There is much improvement, but were they able to solve the problems with healthcare, in itself? Even with the improvement in today’s healthcare, everyone agrees that it still has many problems. But what exactly are they – not only in the US, but in other countries, as well?

For instance, many find it hard to pay for medical bills, and many people pay medical expenses with credit cards, then go into default, then go into debt. Luckily, you can go to to manage credit card debt, for the better; but while there is short term help for this problem, there should be more efficient ways to keep this from becoming a problem.

Knowing what kind of problems the authorities are facing in terms of healthcare is helpful in a lot of ways. It is the awareness of the problem that makes you think well of what you can do to help improve your country’s healthcare system.

Uncoordinated Care

One of the major problems of a lot of healthcare systems in the world, is the lack of coordination. In healthcare, it is very important that medical professionals coordinate care well. This way, you and the many people involved, knows exactly what is going on.

Because of the lack of proper coordination of care, hospitals and health centers cannot offer optimum healthcare to the people who need it the most. The first thing that a coordinated healthcare system has to have is, access to information, so they can successfully aligned healthcare plans.

Wasted Spending

Due to the lack of care coordination, the end result is needless spending of billions of dollars, every year. Of course, it is not just the lack of coordination in the system that causes wasted spending, but it is the major factor of it. Since there is no coordination, there are many mistakes that happen, like people not seeking care while there disease is in its earliest stages. The amount of time and money that could be saved in treating a disease early, can also save one from mountains of debt. Go to if you suffer from overwhelming medical debt.

There is also the way medical professionals order inappropriate tests and procedures – which leads to additional spending. Additional administrative costs also contributes to a lot of wasted spending on healthcare – all because many hospitals are uncoordinated with less-than-capable management. This is really a healthcare problem that the government should really focus on.

Health Illiteracy

There are a very small percentage of people in the world who can claim to be ‘health literate’. These are people who are capable of obtaining and understanding, at least, the basic information about health. They can understand it, process it and use that information to make the proper healthcare decisions, based on the situation.

Health literate people can also acknowledge a plethora of practical issues surrounding their patient’s condition – providing the right medications, understanding nutritional restraints, awareness of health programs the government provides for patients, etc. There are still a lot of people who are health illiterate, and that can bring about negative health consequences, to the patient.

Expensive Cost

A lot of people in the world can agree that the cost of healthcare (even the basic procedures) are expensive, in a number of countries. It is great, how the government really works hard on reducing costs and making quality healthcare affordable, to even the most impoverished. But still, there is a lot left to be desired.

Despite the billions of dollars that the government spends on healthcare, you would think that people would be in better health, currently – but such is not the case; because even with better healthcare, there are still quite a significant number of obesity rates, mortality rate and so on. At the same time, the millions of people who remain uninsured (or under-insured) just add to the stack of medical debt, surrounding healthcare.

And while there are people who are financially literate enough to go to sites like to minimize their debts, the general public at large, has no knowledge on how to follow suit – thus, medical debt escalates. There are various problems in healthcare that really needs immediate attention. There is the low standard of healthcare in rural areas, the ill effective payment mechanisms, the lack of basic healthcare and more. These problems barely scratches the surface of issues involving healthcare, and has yet to be effectively dealt with.

Technology and Internet did make up for what is lacking in the healthcare system – but at a slow pace, because of coordination issues within (and among) hospitals. Technology has also helped well in terms of reducing costs and making quality healthcare more accessible. Thanks to Internet, people in the rural areas can ask for specialized medical attention, even from hospitals that are beyond a practical distance, from them. Digital and mobile health greatly improved the way people access healthcare.

With useful healthcare apps and devices, information is easily disseminated, so healthcare illiteracy is gradually reduced. Given the progressive trends, people can reasonably expect improvements to most of these healthcare problems, sooner than anticipated – while some problems may (regrettably) persist.

What the government and people really must do, is keep each other aware of what is happening, and vigilantly work towards facilitating healthcare for the common good.

West Virginia Health Improvement Institute

A non-profit group that specializes in improving the health care of West Virginians, West Virginia Health Improvement Institute functions as a statewide collaboration among several stakeholders. They aim to improve the health of West Virginians through united initiatives focused on improving promotion and access of healthy lifestyle choices, wellness and optimum evidence-based management of chronic illnesses.

West Virginia Health Improvement Institute supports taking part in practices that pursue the “Triple Aim” that includes controlling and reducing the overall healthcare costs, boosting the healthcare experience of patients and improving the public’s health. The group helps physicians in the implementation of HIT or Health Information Technology. They provide physicians with the technical guidance needed to boost their quality of care, through the integration of electronic health record systems.

The Institute also believes that achieving significant use of Electronic Health Record systems (EHR), for physicians, starts with purchasing certified EHR software. With the sheer number of EHR vendors and software programs, picking the right choice is a time consuming and daunting task. The Institute guides physicians through the process of selecting and implementing the right EHR software. West Virginia Health Improvement Institute also supports the improvement of health information exchanges.

The Institute does not recommend any EMR vendors. However, some regional extension centers have offered a list of preferred EHR vendors or prequalified EHR vendors. These EHR vendors consist of a select group of electronic medical record companies that went through a substantial selection and qualification process. They have shown dedication to the advancement of health information technology. The prequalified EHR vendors adhered to a higher level of interoperability and functionality – allowing more valuable use of EHR software. They are also offering discounted prices as well as consistent terms and conditions, to ensure a smooth and fast implementation of these systems.