RT Journal Article
SR Electronic
T1 The Distressed State of Primary Care in Virginia Pre-Medicaid Expansion and Pre-Pandemic
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 1189
OP 1202
DO 10.3122/jabfm.2021.06.210046
VO 34
IS 6
A1 Brooks, E. Marshall
A1 Huffstetler, Alison
A1 Britz, Jacqueline
A1 Webel, Benjamin
A1 Lail Kashiri, Paulette
A1 Richards, Alicia
A1 Sabo, Roy
A1 O'Loughlin, Kristen
A1 Cunningham, Peter
A1 Barnes, Andrew
A1 Kuzel, Tony
A1 Krist, Alex H.
YR 2021
UL http://www.jabfm.org/content/34/6/1189.abstract
AB Background: Primary care is crucial to the health of individuals and communities, but it faces numerous structural and systemic challenges. Our study assessed the state of primary care in Virginia to prepare for Medicaid expansion. It also provides insight into the frontline of health care prior to an unprecedented global COVID-19 pandemic.Methods: We surveyed 1622 primary care practices to understand organizational characteristics, scope of care, capacity, and organizational stress.Results: Practices (484) varied in type, ownership, location, and care for medically underserved and diverse patient populations. Most practices accepted uninsured and Medicaid patients. Practices reported a broad scope of care, including offering behavioral health and medication-assisted therapy for opioid addiction. Over half addressed social needs like transportation and unstable housing. One in three practices experienced a significant stress in 2019, prepandemic, and only 18.8% of practices anticipated a stress in 2020.Conclusions: Primary care serves as the foundation of our health care system and is an essential service, but it is severely stressed, under-resourced, and overburdened in the best of times. Primary care needs strategic workforce planning, adequate access to resources, and financial investment to sustain its value and innovation.