Free Clinic changes business model to accommodate expanded Medicaid program

The staff of the Fauquier Free Clinic in Warrenton, which also serves Rappahannock County. Courtesy Photo

As of January 1, an additional 400,000 Virginians gained access to quality, low-cost health insurance through the state’s expanded Medicaid program.

The enduring mission of the Fauquier Free Clinic (FFC) is to provide eligible residents of Fauquier and Rappahannock counties with access to comprehensive medical, dental and mental health care. This year, the clinic’s business model underwent extensive changes to accommodate new and existing patients when Medicaid expanded its services for low-income adults throughout Virginia.

“In the past, our medical patients were not eligible for services if they had any type of medical insurance,” said FFC board secretary John McMahon. “Now approximately 60 percent are Medicaid eligible.”

In Fauquier County alone, 1,700 to 1,800 people have become eligible for Medicaid insurance benefits. In Rappahannock County, 300 to 400 people are now eligible. Throughout the state of Virginia, eligibility has been granted to around 400,000 people.

“Medicaid expansion was a great opportunity for the Commonwealth and Fauquier County to provide health insurance coverage for those most in need,” said FFC board member Gregory Bengston. “Changing our business model to ensure that clinic patients who now were Medicaid-eligible had continued access to health care services was a huge accomplishment.”

Board president Jan Selbo shares that after learning that many medical, dental and mental health primary care providers would be unable to absorb new Medicaid patients into their practices, the FFC board unanimously agreed to undergo the process of becoming credentialed Medicaid providers.

This was no small decision; it meant that many long-held processes and procedures, including billing procedures, patient screening and medication acquisition, had to undergo significant changes. Thanks to a partnership with Medicaid experts made possible by generous donor support, new processes were developed, learned and successfully implemented in order to adapt to the new reality and meet patients’ health needs.

“The most important result — and the major consideration for all clinic’s board, staff and volunteers who participated in the decision to begin to accept Medicaid — is that FFC can continue to provide integrated health care to its patients,” said Selbo. “The willingness of the staff and volunteers to undertake this complex process has been heartening.”

According to the FFC’s 2018 annual report, more than 1,700 patients received services for a total of 7,726 appointments, including about 250 pediatric dental screenings. Because of the decision to respond to the Medicaid expansion, the clinic can now serve an even larger population of patients.

“Medicaid expansion is life-changing to many residents,” said McMahon. “Having access to health care, including preventive care, will dramatically improve their quality of life. More importantly, they no longer have to fear the possibility of incurring devastating medical care debt.”

Patients of the clinic are being encouraged to apply for Medicaid with the assistance of FFC staff and volunteers.

The FFC, part of the Fauquier and Rappahannock communities since 1993, provides integrated care for low-income patients with a staff of certified physicians and many dedicated volunteers who donate their time and skills. Preventive care and care for chronic conditions helps contribute to better overall community health and avoids expensive emergency and hospital care for these patients. The FFC receives minimal government support; most funding is provided by generous donors and foundations.

“The wonderful support we receive from our community will continue to be essential to our success,” said Selbo. “Accepting Medicaid patients will not provide the financial and volunteer support needed to continue to provide health care, especially for patients who have limited incomes and do not qualify for Medicaid.”

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