As federal Medicaid cuts and new eligibility requirements put thousands of Hampton Roads residents at risk of losing coverage, finding a doctor may only be the first challenge.
Many people may not know which clinics will accept them or where they can get affordable care.
The Norfolk Health Department is developing two initiatives to help residents navigate both problems: keeping their Medicaid coverage and finding care if they become uninsured.
Dr. Susan Girois, director of the Norfolk Health Department, said about 18,000 Norfolk residents could be affected by the Medicaid changes. Another 5,000 residents may be affected by the loss of enhanced federal subsidies that helped lower the cost of Affordable Care Act marketplace plans.
Girois said Norfolk is building the response from the ground up, with the hope that other communities could eventually adapt the model.
Helping residents keep Medicaid
Norfolk’s planned Medicaid READI stations could be as simple as a table, two chairs and a volunteer ready to point residents in the right direction.
Girois said Norfolk plans to place the stations in different places for residents to ask how to renew Medicaid or reapply for coverage.
The volunteers will explain the first steps, provide application resources and connect residents with trained enrollment workers.
Girois said she eventually wants the READI signs to become as recognizable as the Virginia Lottery logo, so residents immediately know where they can go for help.
“My vision is to see these Medicaid READI posters that can be in churches, in libraries, in parks and rec centers, in nonprofits, in businesses,” Girois said. “People see that and say, ‘Oh, I can walk up there, and someone will be ready to help me with this process.’”
Norfolk is partnering with local nonprofit Eggleston Services to recruit and train volunteers. The department hopes to have 100 volunteers ready for training this fall.
Norfolk Civic Lab, the city’s in-house data group, is also developing a public map that would show residents where to find nearby Medicaid READI stations.
Helping people who lose insurance
For those who lose coverage, the next challenge may be figuring out where to go for care.
A locally developed platform called Front Door is designed to provide that starting point. Uninsured adults can enter their ZIP code and the type of care they need into an online platform, which directs them to nearby free or low-cost services.
Girois said Hampton Roads already has providers offering primary care, dental services, mental health treatment and substance use care. But those services can be difficult to navigate, especially for someone who has just lost insurance.
Without clear guidance, residents may put off treatment, run out of medication or visit an emergency room for a condition that could be handled elsewhere.
Girois said Front Door could help reduce those unnecessary ER visits while preserving emergency departments for patients with more serious needs.
“And who wants to go sit for six hours in the ER just to get an antibiotic when they could have gotten it within a couple hours through the virtual platform?” Girois said.
The platform can also connect patients with free virtual care through Lackey Clinic in Williamsburg.
Amber Martens, Front Door’s project manager, said Lackey Clinic has provided more than 3,000 free virtual visits over the past two years. The service is available to any adult in Virginia, regardless of insurance status, income or immigration status.
Patients can submit their symptoms at any time in English or Spanish. The service is intended for nonemergency conditions such as rashes, urinary tract infections, ear infections, pink eye, cold and flu symptoms and some dental problems.
A doctor reviews the patient’s answers and any photos they submit. The doctor can recommend treatment, provide self-care instructions or send a prescription to the patient’s pharmacy.
The virtual visit may solve an immediate problem while Front Door connects the patient with longer-term care.
Front Door is being introduced gradually in South Hampton Roads. Martens said the clinic expects the program to generate roughly 250 additional virtual visits each month.
“There is access to care,” Martens said. “They just have to know where it is.”
