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Aiding Medicaid: WVU researchers partner with state to evaluate pandemic policy changes

WVU Office of Health Affairs researchers are working with West Virginia Medicaid officials to assess pandemic-related policy changes.

WVU Office of Health Affairs researchers are working with West Virginia Medicaid officials to assess pandemic-related policy changes.

A surge in telehealth usage among Medicaid recipients is one result of the COVID-19 pandemic. Researchers with West Virginia University's Office of Health Affairs are working with state Medicaid officials to find out if continuing those services will help Mountain State residents in the long run.

“When the pandemic was first announced, the state Medicaid agency realized there was a wide spectrum of health services that were going to be interrupted,” said Tom Bias, associate director of program evaluation for WVU’s Office of Health Affairs and associate professor in the Department of Health Policy, Management and Leadership at the School of Public Health.

“That includes things like being able to go into your doctor’s office and receive certain medications. Some medical facilities shut down for elective procedures. Some people had a fear of going to the doctor’s office or going to get prescriptions. The Medicaid organization put into place dozens of internal policies that allowed flexibilities or changes in how Medicaid recipients could receive care and how providers could be reimbursed for that care.”

Examples of new policies include the following: reimbursement provided for health care services delivered to patients by phone or internet, prescription extensions for longer periods of time and the ability of first responders to identify patients able to care for themselves at home rather than being transported to a hospital.

Lasting changes could potentially benefit more than a third of the Mountain State’s population. According to the West Virginia Department of Health and Human Resources, 668,534 of the state’s 1.8 million residents are covered by Medicaid, the joint state-federal program that provides health insurance coverage for individuals and families with low income or disabilities.

“When state officials reached out, our main goal from the beginning was to determine what policy changes were beneficial and may have value in a post-pandemic environment,” said Charles Mueller, principal investigator for the Office of Health Affairs. “We examined 30 policy documents put out in response to COVID-19 comprising 107 different policy changes. From that, we put together a comprehensive evaluation plan guided by sound strategies aimed at providing state policymakers with reliable, trustworthy data that could help improve the lives of West Virginians. So far, we have been successful at that, and we hope to continue to be.”

“The research that WVU conducted is giving us the tools we need to make data-driven policy decisions about flexibilities and service delivery models to better serve West Virginia Medicaid members post-pandemic,” said Cindy Beane, commissioner of the Bureau for Medical Services.

Bias and Mueller collaborated with faculty affiliates from the School of Public Health, School of Nursing, and John Chambers College of Business and Economics, along with graduate student researchers, to organize and analyze the state Medicaid claims data. The team then reached out to patients and providers to gather their feedback about policy changes.

While they are still working to synthesize the data and prepare a report for West Virginia Medicaid, he noted one key takeaway is apparent when it comes to telehealth.

“One of the takeaways is we saw a massive increase in telehealth up front, and while we did see some decline in that, we’re still seeing a lot more telehealth utilization now than we were prior to the pandemic,” Bias said. “In general, patients and providers have really liked the access to telehealth. They’ve liked being able to use it and they’ve seen a lot of benefit to it.”

Mueller also noted that telehealth has offered distinct advantages for patients dealing with addiction and substance abuse issues.

“Telehealth was and continues to be an important resource to help those involved in substance use disorder programs get the counseling and therapy they need to give themselves the best chance at recovery,” Mueller said. “This is especially meaningful for West Virginia communities that were battling the opioid crisis well before COVID-19 further complicated things.”   

The Office of Health Affairs’ work reflects a growing partnership with West Virginia Medicaid to evaluate and track key metrics that must be reported to the federal government. The state has contracted with national firms in the past, but Bias noted that WVU offers unique insight at a cost savings.

“WVU is much more affordable than some of the national consulting firms or others who do evaluation work, and we’re able to tailor our evaluation with a lot of expertise about the state,” Bias said. “With much of the work we do for the state, we’re able to leverage broad expertise through the Office of Health Affairs. We can get people from sociology, education and other areas to assist as subject matter experts. They know West Virginia, and they know West Virginians really well. We give that niche West Virginia expertise a lot better, and we also deliver for a much better price.”

WVU’s Office of Health Affairs strives to improve the lives of West Virginians by partnering with external organizations and agencies, such as West Virginia Medicaid and DHHR, to share faculty expertise and deliver professional services.

Faculty affiliates from across campus collaborate on programs as co- and principal investigators. To explore opportunities to partner with the Office of Health Affairs, contact Natalie Ezzie, director of operations and interim director of program development and management, at or 304-293-8228.

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