5 Things Virginia: Q&A w/ Dr. Danny TK Avula, Bending the Rx cost curve, Medicaid redetermination


Emily Boerger


The general election is right around the corner. With that in mind, State of Reform reached out to several health policy leaders in Virginia for a conversation on how the results might impact health policy in the state. More on that below.

This edition of “5 Things We’re Watching” also features a Q&A with State Vaccine Liaison Dr. Danny TK Avula, an update from DMAS, and coverage of the health issues and policy conversations taking place on the Joint Commission on Health Care.

As always, thanks for reading. And, if you have story ideas or tips for what we should be covering in Virginia’s health sector, we’d love to hear from you!

Emily Boerger
Managing Editor
State of Reform


1. The general election’s impact on health

With less than one week before the Nov. 2 elections, State of Reform Reporter Nicole Pasia spoke with a series of Virginia health care leaders for their takes on how the results could impact the health initiatives prioritized in the coming years. Looking toward the future, Julian Walker at the Virginia Hospital and Healthcare Association says VHHA will focus on responding to the pandemic, addressing the ongoing behavioral health staffing crisis, and expanding community-based services and alternate medical transportation models.

But, Walker says party distribution will impact which policies are taken up by lawmakers. “The partisan makeup of those offices,” he says, “will be a significant determining factor in what issues have prominence, shall we say, during the legislative session. It’s depending on which parties are in power, and which elected officials have been selected by the voters, that will go a long way in determining which issues may or may not come up.”


2. Q&A: Dr. Danny TK Avula discusses COVID misinformation

Virginia is on a downward trend for COVID-related cases and hospitalizations, in part from the state’s high vaccination rates. 82.5% of the Commonwealth’s adult population has received at least one vaccine dose as of Oct. 26, according to the Virginia Department of Health’s COVID-19 dashboard, putting the state ahead of the national vaccination rate of 79.6%.

In this Q&A, State Vaccine Liaison Dr. Danny TK Avula says the department has had to not only address the COVID-19 disease itself, but also the misinformation fueled by social media. He said, “I have a feeling that the fight against misinformation will persist as long as COVID is hanging around, but will also emerge with new and different health threats … Those efforts to really unravel what social media has done to communities — that’s going to be central to this public health issue.”


3. 5 Slides: Bending the Rx cost curve

As a return to normalcy appears on the horizon, the intersection of cost pressures and innovation in pharmacy is becoming a primary topic of concern in health policy. On Tuesday, November 2, from 1:00 – 2:00pm ET, we’ll bring together a panel of experts for a conversation on innovative strategies to bend the Rx cost curve.

Joining our “5 Slides: Bending the Rx cost curve” virtual conversation will be Dr. Robert Popovian, senior fellow for health policy at the Progressive Policy Institute, Sarah Ikenberry, senior communication advisor for the Therapeutic Biologics and Biosimilars Staff at the FDA, and Dr. Kashyap Patel, president of Community Oncology Alliance. This event is free to attend, but you have to register to join us. You’ll be able to pose questions and participate in the conversation as well, just as you do in our conferences. We’d love to have you with us!


4. DMAS prepares for post-pandemic Medicaid redetermination

DMAS is currently preparing for the impending end of the federal public health emergency declaration, which will instigate a lengthy eligibility redetermination process for Virginians who currently benefit from Medicaid. Earlier this month, DMAS Director Karen Kimsey provided an update on the potential disenrollment and its impact on the state budget to the Joint Subcommittee for Health and Human Resources Oversight.

Kimsey says redetermining eligibility could take between 6 and 12 months, and she estimates over 337,000 cases in the state may need to be redetermined. She says the department is working with several partners across the state to provide navigation resources to disenrolled members, and CMS is employing marketing campaigns to encourage individuals to sign up for insurance through the market exchange. DMAS is preparing to submit its 2022 Medicaid forecast on Nov. 1.


5. Eight policy solutions to improve Virginia’s nursing homes

In an effort to address staffing shortages and improve quality of care at Virginia’s nursing homes, legislators deliberated 8 potential policy solutions at a recent Joint Commission on Health Care meeting. The commission identified 4 main challenges facing nursing homes including staff retention difficulties, workforce shortages, and low-quality care that results from being short-staffed.

A presentation from the meeting notes that “One-fifth of Virginia’s nursing homes are not meeting expected staffing levels, disproportionately impacting low-income and Black residents.” Potential solutions discussed at the meeting include: increasing reimbursement rates, requiring a baseline of hours of direct patient care per day, dedicating funding for the Long-Term Facility Nursing Scholarship, and conducting an evaluation of DMAS’s nursing home value-based purchasing program.