The Fund supports networks of state health policy decision makers to help identify, inspire, and inform policy leaders.
A bipartisan group of state health policymakers from both the executive and legislative branches who are focused on improving population health.
Networks of state officials, advocates, and others aiming to invest in and transform primary care.
A program dedicated to advancing state-based efforts to make health care more affordable for residents, employers, and states.
The Milbank Memorial Fund supports two state leadership programs for legislative and executive branch state government officials committed to improving population health.
A leadership development program for early and mid-career state government officials who are committed to improving the health of all people in their communities.
A leadership program for senior state government officials who are committed to improving population health.
The Fund focuses on creating an affordable health care system built on strong primary care and partnerships that improve health outcomes for all.
Improving state leaders’ ability to enact and implement evidence-based health policies.
Advancing policies that create a more prevention- and primary care-oriented health system.
Improving population health through policies that contain health care cost growth.
Our state health policy resources offer relevant data analysis and best practices.
The Fund publishes reports, issues briefs, and case studies on state health policy issues.
Short takes on health policy issues from Milbank staff and guest authors.
Insights from Milbank President Debra Lubar on state health policymaking.
Reported articles and Q&As on timely health policy issues, as well as foundation updates.
Milbank Memorial Fund and Milbank Quarterly webinars featuring state health policymakers and researchers.
Updates and expert contact information for reporters.
The Milbank Memorial Fund is a private foundation that works to improve population health and health equity.
June 20, 2023
Case Study
Maanasa Kona
Jalisa Clark
Emma Walsh-Alker
Megan Houston
Publication
Jul 13, 2026
Apr 14, 2026
Feb 12, 2026
Funding for this project was provided by the National Institute for Health Care Reform. Read a related report reviewing the evidence on the effectiveness of these policies.
This case study of Kanawha County, West Virginia, the fifth in a series, assesses the effectiveness of various policy initiatives to expand access to primary care in the region, particularly for underserved populations. Kanawha County is designated by the federal government as a primary care health professional shortage area for low-income residents, and a variety of policy initiatives have been implemented to make primary care more accessible. They have met with mixed success.
The state government has been particularly proactive in efforts to improve the recruitment and retention of primary care clinicians in the state. More specifically, the state funds several loan repayment and scholarship programs for health professions students, and closely monitors the effectiveness of these programs. However, retaining those professionals has been challenging, and the county continues to experience a shortage of clinicians who serve low-income populations. The state has also made efforts to expand access to affordable health insurance for low-income populations. The decision to expand Medicaid has been especially beneficial.
On the other hand, the state and local governments have taken a hands-off approach toward the federally qualified health centers (FQHCs) and school-based health centers (SBHCs) that provide vital safety net services to the county. State resources and leadership could help them deploy their services to more effectively meet the population health needs of the county.
Like many other rural areas, Kanawha County residents also struggle with lack of access to transportation and barriers to the use of telehealth. While state leaders have taken an interest in dedicating resources to fix the latter, local safety net providers have been left to cobble together their own fixes for the former. State and local leadership could also be leveraged more effectively to help build and sustain trust between underserved communities and the providers who serve them. For example, community health workers (CHWs) have the ability to serve as liaisons between patients and providers and improve health outcomes, but the state has not yet invested in the CHW workforce.
Read the Kanawha County, West Virginia Case Study
Read the Detroit case study
Read the Columbia County case study
READ THE GRANT COUNTY, NEW MEXICO CASE STUDY
READ THE BALTIMORE CASE STUDY
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