William & Mary Participates in Medicaid Reimbursement Rate Project and Non-Profit Research Consortium
Over the summer, Dana Smith MPP’25, had the opportunity to intern with the Virginia Center for Health Innovation (VCHI). VCHI is a healthcare non-profit located in Richmond, run by President and CEO, Beth Bortz MPP’93. Dana’s work consisted of Medicaid research for a collaborative study with William & Mary, and policy drafting for the Research Consortium at VCHI, a network of Virginia health policy experts.
William & Mary is participating in a novel study comparing Medicaid and commercial reimbursement rates for primary care and behavioral health providers in Virginia. The study, entitled “Examining Negotiated Rates for Behavioral Health and Primary Care Providers”, is a collaborative effort between the VCHI and Virginia public universities. The project is headed by VCHI Chief Strategy Officer, Dr. Lauryn Walker, who serves as an adjunct professor at Virginia Commonwealth University. Research partners include Dr. Alison Evans Cuellar, Associate Dean of Research of the College of Public Health at George Mason University, and William & Mary’s Dr. Jennifer Mellor.
The study will utilize newly-released Transparency in Coverage data, as well as data from the All Payer Claims Database to perform this novel comparison of Medicaid reimbursement rates to reimbursement rates for commercial insurances. The study will analyze rate variation across primary care and behavioral health, and specialty services, as well as variation in payment rates across geographic region, provider type, facility type, and provider ownership structure. The purpose of studying variation in rates across payment types is to allow policymakers to evaluate existing rate policies and identify areas of targeted rate adjustment.
This collaboration is more impactful than the results of a single project; it is a pilot for the newly-established Research Consortium at VCHI. The Consortium is a public-private partnership that aims to address a lack of actionable health policy data in Virginia by fostering collaborative research. By being a public-private partnership, the Consortium is a novel organization that can support research proposed by the state, industry experts, and academics.
The motivation behind this initiative comes from the lack of a dominant college of public health in Virginia. Health policy research is split between many academic institutions, resulting in researchers across the state competing with each other for grants and other federal funding unknowingly, limiting state competitiveness for federal funds. The burden of obtaining and sharing health data with research partners further prevents collaboration between institutions, limiting the opportunity for new health research.
Dr. Walker came across this in her work, both in the academic and non-profit spheres, and created an organization that would remedy the fractured network of health policy research. The Research Consortium aims to align subject matter experts across Virginia to those with similar interests, match them with the data they need, and give them the state audience for research findings that a public-private partnership can provide.
The partnership between William & Mary and VCHI through “Examining Negotiated Rates for Behavioral Health and Primary Care Providers” is likely the first of many successful collaborations through the Research Consortium that will pave the way for a new future of health policy research in Virginia.
