Tag: Sentara Martha Jefferson

Categories
News

On a roll: Health department begins vaccinating non-hospital health care workers

Coronavirus case numbers continue to rise in Charlottesville and the surrounding counties. PC: Blue Ridge Health District

The local vaccine rollout process continues. About a month after the first coronavirus vaccines were shipped to hospitals across the country, Charlottesville’s frontline health care employees who work outside of hospitals are now getting vaccinated.

On Monday, the Blue Ridge Health District (formerly known as the Thomas Jefferson Health District) began offering the first dose of the Moderna vaccine to area emergency service providers, dialysis center staff, and Region Ten residential facility staff at its location on Rose Hill Drive.

To expedite the distribution process, on Wednesday the district will begin hosting at least three appointment-only clinics per week for these select health care workers in a new temporary structure set up in the former Kmart parking lot. Red Light Management and the Bama Works Fund contributed funding to set up the facility.

“There are over 1,000 EMS [workers] that we need to vaccinate. There are folks going in and out of the hospital as well. So we want to get them done first,” says Kathryn Goodman, spokesperson for the health district.

The shots will be administered by public health nurses, who received their own vaccinations (and vaccine training) at the end of December. The district is currently working to vaccinate the rest of its staff.

The health district hopes to vaccinate about 500 to 600 people per week at the pop-up clinic.

Because both the Pfizer and Moderna vaccines require two doses to be fully effective, district staff will use a new state Vaccine Administration Management System to properly track appointments and alert patients when they need to return for their second dose.

As more vaccine shipments arrive in the next few weeks, the clinics will open up to other frontline health care workers (hospice employees, primary care providers, dental practice employees, pharmacy workers, Department of Corrections health care personnel, K-12 school nurses, and more) who have had potential contact with COVID or with high-risk patients.

“We’ll have the information sent out to these groups,” says Goodman. “We have quite a long list already of thousands and thousands of individuals who need to get vaccinated as soon as possible.”

UVA and Martha Jefferson hospitals continue to vaccinate their own employees. Other health care entities in Charlottesville and surrounding counties must fill out a BRHD survey indicating how many of their employees need to be vaccinated. The district plans to host additional clinics for health care employees—and eventually other essential workers and high-risk individuals—down the line.

To date, 89,326 people have received the vaccine in Virginia, including 1,542 in Charlottesville, and 1,615 in Albemarle County. However, none have been administered their second dose, according to the Virginia Department of Health vaccine dashboard.

Meanwhile, the health district has seen a record surge in COVID cases and hospitalizations since Thanksgiving, and expects numbers to worsen in the next few weeks following the holiday season. In December alone, there were 2,181 new cases, 86 hospitalizations and 10 deaths—the worst month of the pandemic.

While new cases in the district have remained low since the start of the new year, the district’s positivity rate is currently at 9.4 percent, the highest it has been since April.

Categories
News

A shot in the arm: Vaccine distribution begins for local hospital workers

Nearly one year after the first coronavirus cases were reported in the U.S., UVA hospital and Sentara Martha Jefferson have received their first shipments of the Pfizer vaccine, and begun vaccinating employees who come in direct contact with coronavirus patients. PC: Sanjay Suchek

Last Tuesday, UVA hospital’s ICU director Taison Bell became one of the first people in Charlottesville to receive the newly approved coronavirus vaccine. It was a moment of “mixed emotions,” says Bell, who has worked with COVID patients throughout the crisis.

“It was definitely a good feeling to finally have something that can potentially protect you and your family from COVID-19, but also bittersweet,” he says. “In order to get to this point, so many hundreds of thousands of people have died…It was just ironic that the key to getting out of this was in this tiny little vial.”

Nearly one year after the first coronavirus cases were reported in the U.S., the vaccine is finally available. Shortly after the Food and Drug Administration approved the Pfizer vaccine for emergency use on December 11, it was sent to hospitals across the country, including here in Charlottesville.

Last Tuesday, UVA hospital received 3,000 doses of the vaccine. The day before, Sentara, which runs Martha Jefferson, received 11,700 doses to be shared among multiple facilities. Both hospitals immediately began vaccinating doctors, nurses, and other staff who come in direct contact with coronavirus patients in the COVID-19 unit or the emergency department.

Once these high-risk employees are vaccinated—and the two health care systems receive additional shipments—the shot will be available to essential hospital workers, then to the rest of the staff, with priority placed on those who are medically vulnerable.

Local long-term care facilities will be able to receive on-site vaccination services from pharmacies, including Walgreens and CVS.

On Friday, the Moderna vaccine was also approved by the FDA, and shipped to hospitals two days later.

Both vaccines—currently available only to adults—have over 95 percent effective rates, and require two doses in order to be fully effective. Pfizer’s doses must be spaced out by 21 days, while Moderna’s require a 28-day wait.

Bell says he felt fine after receiving the shot, despite the mild discomfort from the needle. However, recipients may experience mild side effects, including fatigue, chills, body aches, or headaches.

While the long-term effects of the vaccine are still unknown, science and safety were not “cut short” in the approval process, explains Bell.

“[It] is based on a platform called messenger RNA technology, which is novel in the sense that it hasn’t been used in a licensed vaccine before—but the actual science and study behind it has been going on for more than a decade,” he says. “I have no doubt [that] it’s safe.”

mRNA ultimately protects recipients from developing symptoms of the virus. It has yet to be determined if either vaccine can completely prevent COVID-19 infections.

The $9 billion government investment into the vaccine also expedited its development and distribution, explains Bell. And as COVID cases continue to spike around the country, researchers had little trouble finding people infected with the virus who were willing to participate in trials, which can be a challenge when developing vaccines for different diseases.

According to the Thomas Jefferson Health District’s Emergency Manager Jessica Coughlin, the next stages of vaccine distribution will likely take several months to get through.

After health care employees, essential workers—including teachers, paramedics, bus drivers, and service workers—will be next in line for the shot, along with high-risk populations. The Centers for Disease Control has released loose guidelines for vaccine distribution priority, but states and hospital systems still have significant control over the specifics of the rollout process.

The vaccine is not expected to be available to the general public until early summer. But with more than 200 coronavirus vaccines still in development across the globe, this timeline may change. Because the development of the vaccine was paid for by the federal government, it will be free to all who decide to get it.

Developing the vaccine is one thing. Convincing people to take it could be a different challenge. America’s long and brutal history of medical racism has left many people in the Black community mistrustful of the coronavirus vaccine, says Bell.

From 1932 to 1972, in the infamous Tuskegee experiment, the U.S. Public Health Service allowed nearly 400 Black men in Alabama with syphilis to go untreated in order to study the full progression of the disease, causing many participants to suffer from blindness, insanity, and other severe health problems. Meanwhile, in Charlottesville, UVA was a hub for eugenic science. Doctors in Virginia sterilized thousands of Black people without their consent from the 1920s to the 1970s.

“The Black community remembers these insults…[They] must be addressed head-on,” says Bell. “It’s not a matter of just saying, ‘Oh, well trust us now.’ Because the same message was given to people back in Tuskegee and the eugenics movement.”

While there is no single solution to this deep-rooted trauma, Bell encourages his colleagues to “recognize these wounds,” and work to heal them by being honest, transparent, and explaining as much as possible. They must also assure concerned patients that Black people have been a part of the research, development, and trials for the vaccine from the very beginning.

Coughlin says primary care physicians will be best-equipped to help people make good choices around the vaccine, and that the health district is encouraging people to “do their research, look at official sources, and speak with their physicians.”

Categories
Coronavirus News

Ground zero: Local hospitals, health department prepare for coronavirus spike

UVA hospital has been providing medical screening for a variety of diseases as a precaution for the ongoing COVID-19 epidemic. PC: Zack Wajsgras

In just a matter of days, the number of confirmed cases of the novel coronavirus in the Thomas Jefferson Health District has jumped from one to 16, including four in the City of Charlottesville and six in Albemarle County. While the first case was initially thought to be travel-related, it’s now unclear how the individual, a staff member at the UVA women’s center, came in contact with COVID-19, according to the health department. The department is also investigating how the remaining ten individuals contracted the virus, and who else they could have exposed to it. 

With the number of coronavirus cases in Charlottesville only expected to grow, local hospitals are taking extensive measures to prepare for an influx of patients, as well as to assist those currently seeking testing and treatment. In some parts of Italy and, most recently, New York City, an exponential spike in cases has overwhelmed local health care systems, leading to critical shortages of beds and ventilators. 

According to spokesman Eric Swensen, UVA Health System is postponing most clinical visits and surgeries scheduled between now and April 6, with the exception of urgent care, in order to “conserve our resources” and “build capacity to be able to care for folks when they need it.” To minimize the potential spread of the virus, patients at UVA hospital are no longer able to have visitors (with some exceptions). 

UVA staff is also screening everyone before allowing them to enter any facilities, he adds. “If you’re a visitor and are showing any kind of respiratory symptoms or possible exposure to coronavirus, we’re not going to allow you into our clinic or medical center.”

Swensen says there’s been a significant number of people calling UVA health care providers, as well as the UVA health call center, with questions and concerns about coronavirus. In order to prevent the virus from spreading, he urges those who think they may have the virus to call their primary care provider (or, if they don’t have one, the Virginia Department of Health hotline), and not rush to the emergency room. A doctor will then screen them over the phone for common symptoms of the coronavirus—fever, cough, and difficulty breathing—and ask about their travel history and potential exposure to the virus. If they meet the CDC criteria for testing, a doctor can send them to UVA’s referral-only coronavirus clinic. 

In light of the severe national shortages of coronavirus tests, UVA health is now one of the few institutions across the country that has created its own tests, with a goal to have results within one to two days, Swensen says. Due to this increase in testing capacity, it expects to see a spike in local confirmed cases of the virus in the upcoming days. 

“Depending on the severity of their symptoms…not everyone necessarily who gets coronavirus will need hospital care,” Swensen adds. “The first case in Charlottesville is an example of this, where that person is being evaluated and cared for from home.”

According to a news release, one of the other local residents diagnosed with the virus, a UVA student living off-Grounds in Albemarle County who may have contracted it while traveling, is also currently in isolation.

Sentara Martha Jefferson Hospital has taken similar steps to prevent the spread of COVID-19 within its facilities. The hospital has a “fair amount” of ventilators and isolation rooms available, says Vice President of Medical Affairs Paul Tesoriere, and is working with the government to get more testing kits. 

“We’ve identified different areas that we will expand into if we get into a situation where we get a significant influx in patients,” says Tesoriere, “areas that are not being as utilized because the virus has cut down on some procedures or visits.”

A task force meets several times a day to address daily needs and long-term plans.

The TJHD is working closely with both UVA and Sentara, as well as other community partners, to oversee the area’s pandemic response effort and investigate the cases in Charlottesville. But it generally does not supply testing kits or personal protective gear, including masks, goggles, and gloves. Due to the mass shortage of such gear, local doctors and nurses are currently hosting an Equip Cville emergency supply drive (see page 9), collecting donations from businesses, labs, and schools, in partnership with Support Cville. 

“We are working on compiling a list of those in the community that need PPE, and any extra we have we will make sure to get to the appropriate individuals in appropriate health care settings,” says TJHD’s Public Information Officer Kathryn Goodman. “[However,] the demand for [PPE] is unprecedented, and suppliers do not have the inventory to keep up with demand. Local health care providers trying to purchase critical supplies are competing with all providers across the county…efforts like [Equip Cville] are essential to the long-term success of what will be a lengthy response.”

But tests, investigations, and supplies alone will not bring an end to the coronavirus pandemic, Goodman adds. Social distancing, or self-quarantining, is equally as important. 

“We know that there will be cases in this community, and so we’re asking people to stay home as much as possible so that we can prevent and lower the number of cases we see in the area,” she says. “If people do have to go out in public, stay six feet away from one another. [But] if people can just stay home, that’s the best thing we’re going to be able to do to prevent the spread of this.”

When to call your doctor

Symptoms of COVID-19 can range from very mild to severe (or, in some cases, may not occur at all), and usually appear within two to 14 days after being exposed to the virus. They include:

  • Fever
  • Tiredness
  • Cough
  • Shortness of breath
  • Difficulty breathing

If you are experiencing these symptoms, and know or suspect that you’ve been in contact with a person who has COVID-19, or have traveled to an area with a COVID-19 outbreak, you should call your primary care doctor. If you don’t have one, you can also call your local emergency room, urgent care clinic, or a coronavirus hotline:

Contact your doctor early if you’re 60 or older, or have underlying chronic medical conditions, even if your symptoms are mild. Seek medical attention immediately if you’re experiencing any of these emergency warning signs of COVID-19:

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

Updated 3/25 to reflect accurate number of local coronavirus cases

Categories
C-BIZ

“We all have a role to play”: More and more businesses take steps to go green

Firefly owner Melissa Meece, a former environmental consultant, earned her business a certification from the Green Restaurant Association by investing in making the eatery more sustainable. / Photo: Eze Amos

More and more local businesses and nonprofits are looking for ways to operate sustainably. While not everyone is familiar with the “triple bottom line” approach (gauging success by three rubrics: economic, environmental, and societal), most do see efforts to go green as beneficial beyond saving money or reducing waste. And their number includes more than the usual suspects.

“People might not necessarily think of us as among green companies,” says Tiger Fuel Company president Gordon Sutton. “But my brother and I [who took over the family-owned business when their father retired in 2017] are passionate outdoorsmen. We’re looking to the future, and we want to do the right thing.”

Sutton’s brother Taylor, who is COO, was an environmental sciences major; Gordon himself interned at a biodiesel company and always had an interest in renewable energy. Their company, which distributes home heating fuels and petroleum products and owns The Markets convenience stores, began by installing solar panels on two of its stores, the Exxon stations on Preston Avenue in Charlottesville’s Rose Hill neighborhood and in Ruckersville. Sutton saw this step as both a sound financial move–“Our stores and car washes are significant energy users”–and a way to raise awareness and contribute to the community.

He says both customers and employees have been enthusiastic and supportive. The company’s delivery fleet is diesel-powered; “we’ve looked into propane motors, but weren’t thrilled with the results,” Sutton notes. Tiger Fuel is now in the process of assessing its carbon footprint and developing a plan to set significant reduction targets.

While traditional car dealers might also seem to be on the wrong side of climate issues, Carter Myers Automotive’s vice president Peter Borches calls CMA’s Colonial Nissan the company’s “incubator test site” for ways to reduce environmental impact at its 13 dealerships in central Virginia.

Because lighting is a huge energy cost at auto dealerships, Colonial Nissan switched to LEDs and installed a 480-panel solar array designed to produce 93 percent of the facility’s electricity needs. While Borches notes the many incentives for greening the business–cost savings, tax incentives, positive public relations, and marketing benefits–his motives are personal: “My wife and I are worried about [the world] when our children are 50 years old. We need to raise this issue above the political fray, and get as many people as possible in the tent and working together.” An added benefit, in his view, is “our associates have really run with this,” contributing ideas like providing car shoppers with cup- and water-bottle filling stations instead of single-use bottled water, and recycling everything from paper to outdated computers.

Ravi Respeto, president of the United Way Thomas Jefferson Area, says that as a nonprofit, “we’re always looking to reduce costs, but there’s a community leadership aspect as well as an awareness factor” in taking action to lessen environmental impact. United Way began by replacing its building’s old HVAC units with a high-efficiency system that includes programmable thermostats.

Next year, after upgraded windows are installed, the agency is expecting a 10-15 percent savings on its electric bill–and it’s considering solar options down the line. “Climate change affects our lower-income constituencies the most,” says Respeto. Since investing in energy-savings technologies costs money up front, she notes, “there’s an equity aspect to this issue, and we are in the business of equity.”

Firefly Restaurant, as a tenant, can’t make these kinds of capital investments–but it has invested in qualifying as the city’s first Green Restaurant Association-certified eatery. Owner and general manager Melissa Meece, a former environmental consultant, has installed UV film on the restaurant’s huge windows (cutting energy usage for air conditioning by 43 percent); invested in LED bulbs (“expensive up front, but saves energy and staff time, because they never need changing”); and committed to non-toxic cleaning supplies and customer toiletries.

Meece also looks for used or rehabbed Energy Star-rated restaurant equipment: “I’m a big fan of second-hand [she’s also the owner of consignment shop Rethreads], and it saves the energy used in manufacturing.”

It might seem hard for a hospital to go green, but when Sentara Martha Jefferson Hospital decided to create a new campus on Pantops, in 2007, they tried to build sustainability in from the start. The facility (LEED®-certified by the U. S. Green Building Council) uses a range of technological tools to save resources: low-water-usage toilets, automatic controls for temperature and lighting, re-use of condensation water from AC units, and irrigation water supplied from the site’s retention pond.

Focusing on a more sustainable building enabled the hospital to double its square footage (from it’s previous location) without increasing either energy or water consumption. As both a large community institution and a major employer, executive director of support services Catherine Hughes says Sentara Martha Jefferson Hospital sees the need to set a visible example, from recycling in the kitchen (including composting food and reclaiming fryer oil) to encouraging staff to bike to work and even cutting out bottled water and photocopied materials at meetings.

For help in their efforts to reduce their environmental impact, several of these organizations–and others–have looked to the Charlottesville Climate Collaborative, a nonprofit founded in 2017 to coordinate government, business, nonprofit, and community resources to address climate issues. One example: C3 is assisting on Tiger Fuel’s environmental impact assessment.

C3 also runs the annual Better Business Challenge, founded in 2010 by environmental website Better World Betty and the community-based Local Energy Alliance Program. This year (2018-2109) more than 90 businesses and nonprofits participated, taking steps that collectively will save more than $675,000 a year in energy costs and cut 4,331 tons of CO2 emissions. Teri Kent, the original Better World Betty and now C3’s director of communications and programs, says, “There’s great momentum now as businesses are stepping up to this issue. Looking just at the money side of sustainability is too siloed–we all share the same air and water.”

Business sustainability by the numbers: a hyper-local case study

New York City is requiring all large buildings to slash carbon emissions to meet a collective goal of a 40 percent reduction by 2030. In Seattle and Washington, D.C., plastic straws are officially banned at all businesses to reduce plastic waste.

So how is the C’ville business community stepping up on sustainability? From Kardinal Hall to WorldStrides, many area businesses and organ­izations are pledging to reduce their carbon footprint with the help of the Charlottesville Climate Collaborative’s Better Business Challenge, a friendly, year-long competition that encourages energy savings actions and spurs sustainability initiatives on the local level. What kind of tangible impact can they—and did they—make?

The 2018-19 Challenge tracked participant actions, and the energy-savings metrics are in.

Categories
News

Bad lights: Glaring illumination mars night sky

Belmont resident Rick Barnett says glaring lights are degrading residents’ quality of life, and he calls the new ones at Tubby’s “obscene.” Photo by Martyn Kyle

On a night with a full moon, Rick Barnett can see pretty clearly outside his Belmont house. The problem is, he can also see clearly on moonless nights—thanks to an array of lighting, mostly commercial, blazing up into the sky behind his house.

On a recent drive around the neighborhood, he points out a shielded fixture over the back door of a business on Carlton Avenue. “That’s a good light,” he says. Around the corner on the same building, another shoots a bright light up into the trees. “And that one is bad.”

That’s one major sign of light pollution: when the bulb blasts up into the sky rather than illuminating the ground below. Looking south from Barnett’s elevated Chestnut Street backyard, where he’s lived since 1995, he can see dozens of lights, including those of Sentara Martha Jefferson and State Farm on Pantops.

But the worst offenders are in his backyard, on Carlton Avenue, where the lighting on some businesses looks like a landing strip. It’s gotten worse in the past two or three years, he says.

Charlottesville’s light ordinance is pretty much a copy of Albemarle’s, according to light designer Mark Schulyer, who wrote the ordinance in 1998 with UVA astronomer Phil Ianna. Ianna raised the issue of lights obscuring the night sky and making McCormick Observatory useless for serious astronomy.

“The first ordinance was a significant challenge,” recalls Schuyler. It required approval from the General Assembly before the county could adopt it, and buy-in from the community to protect the science being done that requires dark skies.

The limit at the time, 3,000 lumens, came from an Ianna idea. At a meeting of around 300 people, many in the lighting field, he displayed different wattages and asked people to “raise your hand when this is really unpleasant,” recounts Schuyler. That’s what the cap was based on.

The ordinance requires outdoor luminaires to be shielded to avoid spillover into adjoining residential properties—and into the night sky. “Light that bounces up in the sky is wasted light,” says Schuyler.

All of that happened before the biggest revelation in lighting since the invention of the light bulb: the light-emitting diode. The LED saves so much energy, its three Japanese inventors won the Nobel Prize for physics in 2014. It’s also contributed to “a measurable increase in light pollution worldwide,” says Schuyler.

Before LEDs, which are not mentioned in the ordinance, electricians and electrical supply houses were aware of the ordinance and had displays of shielded lighting, he explains.

Now, people are ordering brighter LEDs without shields off of Amazon, and they have no one saying, “You shouldn’t be doing that,” says Schuyler.

In addition to blocking the stars, glaring lights at night may have a harmful effect on vision and health. The American Medical Association warns that artificial lighting can disrupt circadian rhythms, which can lead to health risks including diabetes, mood disorders, and cancer.

Ordinance enforcement is a “tricky business,” says Schuyler, because of limited staff resources and the fact that someone has to work overtime to check lights at night.

Lighting enforcement is complaint-based, and the city averages fewer than one complaint a year, says Assistant Zoning Administrator Craig Fabio. Zoning staff works with offenders to bring them into compliance, and fines are possible, he says.

City Councilor Heather Hill has been to Barnett’s place. “It was eye-opening to me,” she says. While she believes the bleed over from commercial lights that affects residents is unintentional, “I do think we have a lot of opportunity to enhance our lighting ordinance.”

Both she and Schuyler say the PLACE Design Task Force is looking at the issue.

Barnett has had some luck working with neighbors himself. A year ago he approached Tiger Fuel and “got a very good response,” he says. The company put up new fixtures on the front of its building, and “now it’s nothing like the locomotive lights that were coming toward me.”

He also cites success with City Walk apartments, which shielded its lights after neighbors complained. Barnett says Beer Run now cuts off the lights on its sign after it closes.

He’s less pleased with Tubby’s new lights, which illuminate the back of Richmond Camera. “It’s obscene. Obscene,” says Barnett. Tubby’s owner, John Fargale, did not respond to a call from C-VILLE.

Some people mistakenly believe that the more lights, the safer a property is, says Schuyler. He calls it “security theater.”

Police Chief RaShall Brackney agrees that lighting doesn’t necessarily deter crime. “People become immune,” she says. And the International Dark-Sky Association says that glare can decrease safety by creating deep shadows that make it harder to see a lawbreaker from constricted pupils.

Barnett counts seven sources of light that intrude into his bedroom windows or yard during winter months, and that doesn’t include the streetlights shining on the front of his house.

Before, “It was all delightfully dark,” he says. “I could sit on the roof and see the stars.”

Correction May 2: Barnett lives on Chestnut Street, not avenue.

Categories
News

Secret services: Why is it so hard to find out what your doctor’s visit will cost?

It’s not that easy to find out what a doctor’s visit will cost, especially at the appointment. Photo by SKYCLAD Aerial

When you buy a house or a car, you know how much it’s going to cost. That’s not necessarily the case when you go see a doctor, especially if you don’t have insurance, a local woman discovered on recent visits to a UVA clinic.

Sara Ensey is a self-pay patient, and when she went to UVA Primary Care Riverside December 12, she asked twice what the cost would be before she saw a healthcare professional, and was told, “We cannot give you that information,” she says. One person added, “You don’t have to pay all at once.”

“This is an outrage and a disgrace, and it should not be legal,” says Ensey.

Too many people have to choose between medical care and other necessities, and UVA Health System should be transparent about costs, she says.

She had a similar encounter in June, and later received a $385 bill for a 10-minute primary care visit that involved no labs, blood work, or x-rays. Worse, she says, the bill had none of the codes that categorize the services she received.

“We do provide price estimates upon request,” says UVA Health System spokesperson Eric Swensen. Patients need to call or visit uvahealth.com for an estimate, which can take up to two days, according to the website.

Ensey questions why the burden is placed on a patient to log onto a website or place a phone call to obtain the information. “If they are so forthcoming with pricing information, why the hurdles? I asked in person and was denied—twice.”

Swensen says the estimate depends on several factors, including the complexity of care a patient needs and the details of her insurance coverage, and it can take some time to develop an estimate that is as accurate as possible. “The estimate review process is detailed to capture procedures and tests that may be needed together with the patient’s insurance coverage to best determine the patient’s out-of-pocket estimate,” he says.

But Ensey thinks the information should be available at a patient’s appointment. “How is a patient to self-advocate and make a cost-benefit analysis if no one can tell you what the cost will be?” she asks. “That’s ridiculous.”

Ensey recently moved here from Vermont, and she says the University of Vermont is required to provide patients estimates at the time of the visit. And some health systems offer online calculators specifically designed for just this purpose.

“It surprises me UVA doesn’t have something similar,” she says.

Charlottesville’s other main health care provider, Sentara Martha Jefferson, doesn’t seem any different. Spokesperson Jenn Downs says in an email, “Our patient financial service customer service representatives can provide an estimate of total charges.” But as at UVA, that must be done in advance.

Ensey wants to make it clear that the issue is not about pointing fingers. “This is about raising awareness so that the situation can change for the benefit of patients in the greater community and beyond—because it won’t if no one calls attention to it.”

Categories
News

Morbidity rates: Optima’s health insurance premium calculations challenged

Sara Stovall and Ian Dixon met with Senator Tim Kaine, far right, and Kristen Molloy, his senior health policy advisor, and legislative correspondent Nicholas Widmyer. Photo courtesy Senator Kaine's office.

 

In November, Sara Stovall was grappling with a health insurance premium that had skyrocketed from $940 a month to $3,000 for her family of four in the Charlottesville market, which found itself with the highest rates in the country.

Now Stovall says she has a better idea of why this area’s rates are so high. She believes Optima Health—the area’s only individual policy provider—used a factor in calculating health insurance premiums that the U.S. Department of Health and Human Services forbids—and she says its incoming CEO admitted as much in a December 14 meeting.

Stovall and fellow Charlottesville resident Ian Dixon met with Optima CEO Michael Dudley and his successor, Dennis Mathias. It was there that in explaining why Charlottesville’s rates are so high, according to Stovall and Dixon, Mathias said, “The morbidity of the people buying in this marketplace is higher than other parts of the state.”

The two say Dudley further explained that morbidity is “how sick people are.”

And that’s a big no-no in HHS’ 2018 Unified Rate Review Instructions: “Geographic factors may not reflect differences in morbidity by region.”

To Dixon and Stovall, inclusion of morbidity as a factor would explain why a Charlottesvillian would pay 68 percent more for a bronze health plan than someone in the Hampton Roads area.

They point out that Optima’s filings use an area rating factor for Charlottesville that’s 58 percent higher than Hampton Roads—but they say Anthem’s area rating for Charlottesville was lower than Hampton Roads. “There’s no history of our area being rated this high,” says Dixon.

Another factor they question is the difference between Optima’s individual policy rates and the small group rates it offers businesses. In Charlottesville, the small group rate is significantly lower than an individual plan, despite both using the same providers and the same provider reimbursement rates, says Dixon.

“We don’t see any justification for the 58 percent difference from small group and individual rates,” says Stovall.

“They said small groups are healthier,” says Dixon. “The health of the population and morbidity cannot be used in setting the rates.”

In a statement from Optima’s Dudley, he does not address the question of whether morbidity was used in how the company calculated its Charlottesville premiums.

“We have carefully revisited our 2018 premium calculations,” and determined the calculations were accurate, reviewed by third-party actuarial experts and approved by the Virginia Bureau of Insurance and the Centers for Medicaid and Medicare Services, he says.

Optima did not respond to a question about the statements allegedly made by Dudley and Mathias on morbidity, but says, “This is a very complex issue, and we correctly addressed all appropriate adjustments in accordance with state and federal laws, and, as required by the regulations, the geographic factors did not reflect differences in morbidity by region.

Stovall and Dixon met with people from Virginia’s Bureau of Insurance, and say that while those in the meeting initially were skeptical about their concerns, “by the end of the meeting they felt our concerns were valid,” says Stovall.

“You’ll have to rely on what they’re telling you as far as the meeting goes,” says Ken Schrad, spokesperson for the State Corporation Commission, under which the Bureau of Insurance resides.

“The bureau can always seek further information to be responsive to an inquiry or complaint from an already accepted filing,” he says.

Would Optima’s request for premium rates that are the highest in the country raise any red flags at the Bureau of Insurance? Says Schrad, “There’s so many factors that go into filing for insurance plans. To point out one factor alone as driving something would be hard to do.”

Optima maintains that when Anthem pulled out of the Charlottesville market, leaving zero insurance providers, despite business advisors telling the insurer to steer clear, it was asked by the commonwealth to come in and cover as many people as it could.

Optima Health is owned by Sentara, which also owns Sentara Martha Jefferson Hospital here. Optima did not respond to a question about whether that also was a factor in its decision to offer coverage here.

The company did say it had lost more than $30 million in the past three years in Virginia under the Affordable Care Act and this “is not sustainable.”

And Dudley’s response to Stovall and Dixon suggests they move on. “The reality is that premium rates are locked in for 2018,” he says. He adds the wish that “Washington would establish an environment that allows for affordable health plans.”

While Dixon considers the response “evasive” in not addressing “the crux of our complaint about morbidity,” he and Stovall are with Dudley on one point. They plan to escalate with the Bureau of Insurance and go back to their senators and congressman to figure out why Charlottesville can’t get affordable care.

Updated December 27 with Optima’s denial that morbidity was used to calculate Charlottesville’s health insurance premiums.

Categories
Living

LIVING Picks: December 6-12

The Downtown Business Association of Charlottesville parades local holiday cheer with floats, marching bands, living history performers and more.

FAMILY
Virginia Glee Club Christmas concert
Saturday, December 9

The UVA Glee Club performs seasonal favorites with plenty of opportunities for the audience to sing along. $5-15, 8-10pm. First Presbyterian Church, 500 Park St. virginia gleeclub.org

NONPROFIT
Holiday Heritage Parade
Saturday, December 9

The Downtown Business Association of Charlottesville parades local holiday cheer with floats, marching bands, living history performers and more. Free, 10am. Downtown Mall. downtowncharlottesville.net

HEALTH & WELLNESS
Taking control of stress
Thursday, December 7

This class (part of a series) focuses on the effects of stress—both acute and chronic—on our bodies and health. Learn several techniques for stress management. Free, 1- 2pm. Sentara Martha Jefferson Health & Wellness Center Patient Education Room, 590 Peter Jefferson Pkwy. 654-4510.

FOOD & DRINK
Christmas caroling party
Friday, December 8

While enjoying a glass of wine or hot chocolate by the fire after dinner (included in price), join the UVA Sil’hooettes in singing Christmas carols. $20, 6-9pm. Veritas Vineyard & Winery, 151 Veritas Ln., Afton. veritaswines.com