Virginia Health Care Coverage and Access Report

On April 11, 2022, the General Assembly of Virginia passed a bill that requires the Department of Health to develop and implement a methodology for evaluating the efficiency and productivity of carriers and managed care health insurance plans.

The Department of Health, through its contract with Virginia Health Information (§32.1-276.4) and in consultation with the Bureau of Insurance of the State Corporation Commission shall:

1. develop and implement a methodology to review and measure the efficiency and productivity of health care providers and carriers, as defined in §38.2-3407.10 of the Code of Virginia, other than limited scope dental or vision plans, and managed care health insurance plans, and
2. make available to the public on a website maintained by Virginia Health Information such data and information and other reports collected or produced as a result of implementation of such methodology. The methodology shall be designed to foster transparency and competition among both carriers and health care providers and to assist consumers in making educated decisions regarding options for health care coverage and access.

The report below is the outcome of a stakeholder work group convened by the Bureau of Insurance and composed of representatives from the Virginia Department of Health, Virginia Health Information, the Virginia Association of Health Plans, the Virginia Hospital and Healthcare Association, the Medical Society of Virginia, and others. The stakeholder work group developed a methodology and identified data sources to foster transparency and competition among both carriers and health care providers, as well as to assist consumers in making educated decisions regarding options for health care coverage and access.