The Fund supports networks of state health policy decision makers to help identify, inspire, and inform policy leaders.
The Milbank Memorial Fund supports two state leadership programs for legislative and executive branch state government officials committed to improving population health.
The Fund identifies and shares policy ideas and analysis to advance state health leadership, strong primary care, and sustainable health care costs.
Keep up with news and updates from the Milbank Memorial Fund. And read the latest blogs from our thought leaders, including Fund President Christopher F. Koller.
The Fund publishes The Milbank Quarterly, as well as reports, issues briefs, and case studies on topics important to health policy leaders.
The Milbank Memorial Fund is is a foundation that works to improve population health and health equity.
June 20, 2023
Case Study
Maanasa Kona
Jalisa Clark
Emma Walsh-Alker
Megan Houston
Publication
Sep 16, 2024
May 20, 2024
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Funding for this project was provided by the National Institute for Health Care Reform. Read a related report reviewing the evidence on the effectiveness of these policies.
This case study of Kanawha County, West Virginia, the fifth in a series, assesses the effectiveness of various policy initiatives to expand access to primary care in the region, particularly for underserved populations. Kanawha County is designated by the federal government as a primary care health professional shortage area for low-income residents, and a variety of policy initiatives have been implemented to make primary care more accessible. They have met with mixed success.
The state government has been particularly proactive in efforts to improve the recruitment and retention of primary care clinicians in the state. More specifically, the state funds several loan repayment and scholarship programs for health professions students, and closely monitors the effectiveness of these programs. However, retaining those professionals has been challenging, and the county continues to experience a shortage of clinicians who serve low-income populations. The state has also made efforts to expand access to affordable health insurance for low-income populations. The decision to expand Medicaid has been especially beneficial.
On the other hand, the state and local governments have taken a hands-off approach toward the federally qualified health centers (FQHCs) and school-based health centers (SBHCs) that provide vital safety net services to the county. State resources and leadership could help them deploy their services to more effectively meet the population health needs of the county.
Like many other rural areas, Kanawha County residents also struggle with lack of access to transportation and barriers to the use of telehealth. While state leaders have taken an interest in dedicating resources to fix the latter, local safety net providers have been left to cobble together their own fixes for the former. State and local leadership could also be leveraged more effectively to help build and sustain trust between underserved communities and the providers who serve them. For example, community health workers (CHWs) have the ability to serve as liaisons between patients and providers and improve health outcomes, but the state has not yet invested in the CHW workforce.
Read the Kanawha County, West Virginia Case Study
Read the Detroit case study
Read the Columbia County case study
READ THE GRANT COUNTY, NEW MEXICO CASE STUDY
READ THE BALTIMORE CASE STUDY
