INSIDE WVSMA
Message from the President
Joe Prud’ homme, MD, FAAOS
Physicians’ roles in society are changing. Eighty percent of physicians are now employees of large groups. The West Virginia State Medical Association( WVSMA) needs to cultivate large, group memberships.
To avoid burnout, doctors need to become involved in their organizations so they will participate in planning and don’ t feel hard done by. In order to do this, doctors must improve their leadership and administrative skills— the WVSMA can help with this.
Physicians need to understand federal and state mandates as well as the difference between legislation and regulation. While Congress may mandate through laws, most of the regulatory burden on physicians comes from the Centers for Medicare and Medicaid Services( CMS). If you combine the Veterans Health Administration, TRICARE, federal employee insurance, Patient Protection and Affordable Care Act( Obamacare) subsidies, and Indian Health Service with Medicare and Medicaid, the federal government pays for nearly half of United States healthcare. Federal and state legislatures, recognizing where their money goes, increasingly legislate healthcare. If you don’ t avidly participate, you and your patients pay the price. If you don’ t have a seat at the table, you are on the menu.
You must advocate for your patients and the practice of medicine in order to be a maximally effective physician. You need to devote your time and money to elect officials who believe what you believe. Buying votes is expensive and temporary. Electing like-minded officials is the best way to protect your interests and those of your patients. The WVSMA can help you become effectively involved.
Under the One Big Beautiful Bill Act, many changes have been made to Medicaid. A significant percentage of the cuts were achieved by removing coverage from persons who are not in the country legally. Another provision in the bill cuts Medicaid in a way that could have a large impact on West Virginia( WV). Starting in 2026, working age individuals who are not disabled will be required to work 80 hours per month to keep their Medicaid benefits. This rule could impact up to 140,000 West Virginians. Some rural hospitals are afraid they could go bankrupt if these cuts occur. Estimates are that WV could lose over $ 1 billion a year in Medicaid funds.
As a partial remedy, Congress appropriated grants to states for up to $ 100 million per year which are to be used for innovative rural healthcare projects. WV submitted its application to the federal government for the rural healthcare funds. New ideas were the theme. Nutrition, clean water, and wellness care instead of sickness care were favored topics. At the time of writing this letter, I have supplied Governor Patrick Morrisey’ s task force with eight suggestions. One hundred million dollars per year for five years is a lot of money, but it is only 10 % of the money we may lose from Medicaid cuts. Morrisey had a roundtable of medical and business leaders that helped prepare WV’ s application.
Patient Protection and Affordable Care Act subsidies are also on the chopping block. During the COVID-19 pandemic, the federal government was generous with subsidizing individual healthcare premiums purchased through the Patient Protection and Affordable Care Act exchanges. These subsidies were temporary and are expiring. If they expire, Patient Protection and Affordable Care Act premiums in WV may increase by 200 % or more. This increase could be devastating for the impacted individuals.
Switching gears, I would like to focus on modernizing the WVSMA. Our organization is a bit Luddite. We need to hire new employees who can leverage social media and deliver our message in a more contemporary format to our members and the public. We need to be social media influencers. We are scarce in that space at present. I want to be able to deliver our communications to you in your favorite format. Let me know your preference. As we re-create our organization to better serve doctors and patients in an artificial intelligence-driven world, please help me keep the innovation pedal to the metal so we don’ t get run over!
Joe Prud’ homme, MD, FAAOS
8 • www. wvsma. org