By Maanasa Kona, Jalisa Clark, and Emma Walsh-Alker

Robust primary care infrastructure is associated with better population health outcomes and reduced health disparities. However, many people in the U.S. lack primary care access—particularly communities of color and people living in rural areas.

In a new case study, published in collaboration with the Milbank Memorial Fund, CHIR researchers examined stakeholder efforts to improve primary care access in Kanawha County, West Virginia—an area designated as a primary care health professional shortage area for low-income residents. Kanawha county is home to the seat of the state government, Charleston, but also includes rural regions outside of the city. Researchers found that policy initiatives implemented at the local and state level have had mixed results.

West Virginia has invested heavily in improving the recruitment and retention of primary care clinicians practicing in the state by establishing multiple scholarship and loan repayment programs for health professions students. These programs have helped draw clinicians to West Virginia, though retention remains a challenge. The state’s decision to expand Medicaid has also significantly improved access to primary care for many low-income residents.

On the other hand, West Virginia’s hands off approach toward vital safety net clinics like federally qualified health centers (FQHCs) and school-based health centers (SBHCs) has hindered these providers’ ability to further expand their reach and services, and the state has yet to take a leadership role in supporting and expanding the supply of community health workers (CHWs). Further, Kanawha County residents struggle to access primary care because of transportation and broadband-related barriers.

You can read the full case study here.

This work was supported by the National Institute for Health Care Reform.