Authority for Study
The Joint Commission on Health Care was created by the 1992 Session of the Virginia General Assembly, pursuant to Senate Bill 501 and House Bill 1032. This sixteen-member legislative commission, with a separately staffed agency, continues the work of the Commission on Health Care for All Virginians (Senate Joint Resolution 118, 1990 Session).
1993 Commission Activities
The Joint Commission's 1993 activities included regional Commission meetings, a number of subcommittee meetings, and oversight of several task groups. The three subcommittees reviewed issues related to health insurance, the health workforce, the academic medical centers, and indigent care financing. Four task groups, consisting of Joint Commission staff, executive branch staff, and citizens, also reported to the Joint Commission. Individual task groups were charged with reviewing federal reform efforts, the organization of the long-term care system, health care fraud, and organized delivery systems. The work of the subcommittees and the task groups was reported to the Joint Commission at its monthly meetings.
The Joint Commission held seven meetings in 1993 at locations across the State. The May meeting was held at the General Assembly Building in Richmond. At this meeting staff reviewed the status of the 1993 legislative and budget recommendations, and the 1993 Joint Commission workplan. The May meeting also featured the first of a series of monthly staff reports on the status of federal health care reform. Finally, Secretary Cullum provided a status report on the State's efforts to reorganize the long-term care system.
The June meeting, also held in Richmond, focused on health insurance reform. The Joint Commission heard public comment on Virginia's small group insurance market reform bill, House Bill 2353. Insurance Commissioner Foster also offered his perspective on the bill. The comments of the public and the Commissioner were taken into consideration by the Health Insurance Subcommittee in its efforts to refine House Bill 2353.
The July meeting was held in Charlottesville. Representatives from the Commonwealth's three academic medical centers - the Medical College of Virginia of Virginia Commonwealth University, the Medical College of Hampton Roads, and the University of Virginia Health Sciences Center presented their collaborative plans to increase the supply of generalist physicians in the Commonwealth. These proposals were then reviewed by the Health Workforce Subcommittee.
The vice presidents from the three academic medical centers also presented their response to House Joint Resolution (HJR) 623. HJR 623 requested the Joint Commission to work with the Governor in developing a long-term policy for the role of the academic medical centers in indigent care and medical education. The meeting concluded with a presentation by Mark R. Warner, Chairman of the Virginia Health Care Foundation, on grants awarded throughout the Commonwealth for programs addressing primary care needs.
The September meeting, held in Norfolk, featured a review of eastern Virginia health care issues by C. Donald Combs, Ph.D., of the Medical College of Hampton Roads. Secretary Cullum presented a proposal to request information from providers on their willingness to serve Medicaid enrollees on a capitated payment basis. Roice D. Luke, Ph.D., presented an overview of the growing trend toward integrated delivery systems in the nation and in the Commonwealth. Louis F. Rossiter, Ph.D., provided the Joint Commission with a comparison between the Virginia Essential Benefits Plan and the national benefits plan proposed by the Clinton Administration.
The September meeting concluded with testimony from two citizens. Ms. Nancy Davenport Ennis presented the findings of the Citizens' Task Force on Coverage of Autologous Bone Marrow Transplants and the implications for the future of health care delivery and finance. Mr. Frank K. Mattson presented his views on health care reform, stressing the value of preventive services in controlling health care costs.
The October meeting was held in Roanoke. The Joint Commission heard a staff analysis of Virginia's reform efforts compared to other states and the Clinton proposal. Various members of the Roanoke community addressed the Joint Commission about the strengths and limitations of the health care system in the region, as well as concerns about the Clinton reform proposal. Finally, Secretary Cullum provided a comprehensive overview of long-term care in the Commonwealth with particular emphasis on the need for restructuring and consolidation at the State level.
The November meeting was a two-day retreat held at Airlie, in Northwest Virginia. The retreat gave the Joint Commission an opportunity to refine the information it had received during the year into a preliminary annual report and legislative agenda. The Joint Commission reviewed proposals for legislative action pertaining to health insurance, the health workforce, health care costs and quality, the academic medical centers, Medicaid, and long-term care. A number of citizens representing providers, insurers, and purchasers of health care attended the retreat, and many addressed the Joint Commission individually or as part of a panel.
At the December meeting in Richmond, the Joint Commission's legislative agenda and annual report were further refined. The Joint Commission also received information on a controversial practice in which some insurance companies fail to pass on the benefits of their negotiated discounts to subscribers in the form of reduced coinsurance payments. The Joint Commission heard from the Insurance Commissioner as well as representatives of the insurance industry and consumers.
