Mason Health Care Policy Experts Guide Fairfax County in Responding to Affordable Care Act

By Michele McDonald

Len Nichols

Len Nichols

Guided by community-wide planning and input from Mason researchers, Fairfax County plans to fill gaps in dental, behavioral, and primary care services to respond to changes prompted by the Affordable Care Act.

Integrating the county’s health care offerings with those offered by other public, nonprofit, and private services is a key action kicking off this year, says Brenda Gardiner, policy and information manager of Fairfax County’s Department of Administration for Human Services.

Two health care policy experts from Mason’s College of Health and Human Services (CHHS)—P.J. Maddox, a professor and chair of Mason’s Department of Health Administration and Policy, and Len Nichols, director of the Center for Health Policy Research and Ethics—spearheaded the report, “Recommendations to the Fairfax County Health Care Reform Implementation Task Force.”

“It’s a massive undertaking,” Gardiner says of the report and the recently published county action plan. “Just the appendix is worth its weight in gold in terms of telling us who’s out there to provide services.”

Fairfax County plans to find some answers as it streamlines the process of getting people the help they need. “How do you share resources in the community, and who pays for what?” Gardiner asks.

P. J. Maddox

P. J. Maddox

For example, the county is looking at the role of state and federal government in dental care, Gardiner says. “What we’ve learned is there’s care in place but there are holes.”

Many residents low on funds and with dental problems turn to the nearly 20-year-old Northern Virginia Dental Clinic. The Jeanie Schmidt Free Clinic in Herndon, which recently joined the Loudoun Community Health Center to form HealthWorks for Northern Virginia, gives primary care to those in need. Mason’s School of Nursing works with the clinic.

Giving low-income patients a home base for primary care will help track the care they’re receiving and decrease duplication, Maddox says. “Make sure the left and right hand not only know what they’re doing but that they agree on who’s supposed to be doing what,” she says.

It’s this coordination of effort, even across geographic and political boundaries, that will “make everybody’s dollars go further,” Maddox says. The Mason report strongly recommends that the county provide leadership in this area.

In addition, the report advises that the county improve its information system so data can be standardized and shared with other organizations. Terms such as “episode,” “client,” or “visit” could mean specific things for one provider but mean something entirely different to another clinic.

Medicaid, which pays for services for low-income people, is another key component in the county’s future plans, Nichols says. Virginia could decide this year to expand Medicaid so more people could qualify and receive federal money. The county would benefit because more residents would be eligible for Medicaid, taking the burden off the county, he says.

“There are a lot of cost-effective reforms that could be affected if the state adopts Medicaid reform,” Nichols says.

One such service is mental health. A disproportionate number of people who are low-income and currently don’t qualify for Medicaid have mental health issues, Nichols says. The county steps in to help.

Fairfax County is the safety net for many people in need, Maddox adds.

Professor and PhD student Beverly Middle learning at Inova Hospital

“We have an embarrassment of riches,” Maddox says. “We’re the second wealthiest county in the entire United States. If you look at the statistics in aggregate, we look great. The problem is Fairfax County has more people than some states. A pocket of need in Fairfax County may be small given the size of the county, but it is large in number and has a significant impact on the county budget and quality of life in the area.”

If more patients are able to pay for services because they’re newly eligible for Medicaid, then the county may need to adjust its sliding scale and charge for a new group of individuals who can pay. “They can pay way more than zero,” says Nichols, adding that the money earned is then used to pay for other health services.

The county plans to make sure businesses and residents know their health care options and help them navigate health care subsidies, Gardiner says. “We’re not sure if businesses understand what’s available to them.”

As the process moves forward, Gardiner says, the county will draw upon the expertise of these and other Mason professors, including Mark Meiners, a CHHS professor who specializes in long-term care, and Paul Clark, an assistant professor in the Department of Social Work.

The effort Fairfax County expends in health care now will pay off, Nichols says.

“It’s always in the county’s best interest to make sure that a baby is born healthy,” Nichols says. “We are responsible, so let’s make that baby healthy.”

This article originally appeared on the university’s News site.

To read more stories about Mason, check out the university’s News site.

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