8-25-2024 1:48pm

Small medical offices could be viable East of the River, physicians say

Catherine Hollingsworth Editor

Illustration: Designstripe.com

By Lindiwe Vilakazi
and James Wright

At a time when private medical practices and health care workers are on the decline nationally, there is a potential market for these professionals in an underserved area of the nation’s capital, doctors say.

Two new hospitals are slated to open next year in the District of Columbia, bringing more providers to Southeast D.C. where historically there has been a shortage of health care professionals and underserved Medicaid-eligible patients. The District’s federal-state Medicaid program provides health care coverage for low-income and disabled people.

Even with major new medical centers under construction east of the Anacostia River, there is room in the market for small private practice physicians who want to serve Medicaid patients, doctors say. But these independent medical offices likely would require financial incentives, assurances about security and amenities to make the move across the river, three doctors explained.

Gerard Davidson of Davidson Dental had never considered opening his practice East of the River, especially while preparing for retirement in the sunset of his career. However, he shared some insights on the market potential for medical providers.

“East of the River is an underserved community. D.C. Medicaid pays really well, so it’s not a financial issue. If you have clients who are on D.C. Medicaid, you’ll be fine, [and] if you have clients with regular insurance, you’ll be fine,” Davidson said.

As for any potential downsides, Davidson said: “The only negative could be, well, I don’t even want to say crime.” He added, “Certain areas are a little rough, but I have some friends who live in Southeast, so I frequent the area [here and there]. Every so often I may think about a car being stolen or something, but I don’t think about that heavily, it’s just something to consider,” Davidson said.

Underserved patients in Anacostia

Between 2021-2022, District of Columbia health officials found that the greatest shortage of health care professionals was among residents enrolled in Medicaid. In Anacostia, the Medicaid-eligible population lacks access to primary and mental health professionals, according to a 2023 update of community health data.

Andrea Sullivan, a physician whose practice is located in Takoma Park, is not necessarily looking to switch office locations. However, she said she is always inclined to serve communities in need of equitable medical attention, while noting that organic grocers, security, and financial support would be welcome incentives if she were to expand her practice East of the River.

“At this point, I am not moving my office again. However, if I were to do that, I would move East of the River. The need is great, and the incomes are not commensurate,” Sullivan said.

The local government could help sweeten the deal for physicians that are looking to head across the river, she said. “I would have to be subsidized by the city to make it work,” Sullivan said. “Both tax breaks and office space would be necessary—also parking accessibility and security, especially in the evening.”

Locating medical services near healthy food stores also could appeal to physicians looking to open offices East of the River, she said. “There would also need to be at least one, hopefully two higher quality grocery stores that would make organic foods available.”

Most physicians work for large employers

Over the past decade, there has been a shift away from doctors working in private practice to large corporate employers, Ashish K. Jha, dean of the School of Public Health at Brown University, testified at a congressional hearing in May.

“Nearly 4 out of 5 physicians are now employed by a hospital, health system, or other large corporate body,” according to Jha’s written testimony to the U.S. House Ways and Means health subcommittee. Hospitals and corporate entities have bought up private practices and used this increased market power to negotiate higher prices from private insurance companies, Jha wrote.

The hearing examined the declining number of doctors in private practice. In a statement prepared for the hearing, the American College of Physicians called on Congress to enact policies that not only increase the overall number of primary care physicians, “but also ensure that these additional PCPs are located in the communities where they are most needed.”

In Southeast D.C., the Cedar Hill Urgent Care Center GW Health opened in the District’s Ward 8 in 2022 and the Whitman-Walker Max Robinson Center recently closed its doors on MLK Avenue and opened a larger facility at St. Elizabeth’s in August.

In addition, new hospitals at Cedar Hill Regional Medical Center GW Health and Whitman-Walker Max Robinson Center are slated to open in 2025. Both are located East of the River on the St. Elizabeth’s east campus.

Cedar Hill is under the management of Universal Health Services, a for-profit public company, while Whitman Walker Max Robinson Center is a non-profit community health center.

A respite center serving homeless women, Unity Health Care’s Hope Has A Home for Women in the Anacostia neighborhood, opened in March and is yet another sign of new medical services cropping up in Ward 8. Unity Health Care is a nonprofit organization with the largest network of community health centers in the District.

New law expanded DC's Medicaid

Not everyone perceives east of the Anacostia as short on medical providers given the new facilities opening there. Having served patients in Southeast, Duane Taylor, chief executive officer of Metro Health, said there are misconceptions of a saturated market East of the River.

But in Taylor’s view, there is always market space for healthcare in underserved and economically affluent communities alike, especially when considering the “robust” Medicaid in DC, he said.

“There's never saturation, there is plenty of work,” Taylor said.

He added that the Affordable Care Act has helped expand the Medicaid market in DC. “Medicaid in DC is very robust, so you can make [close to] $80,000 and receive Medicaid in D.C., largely because of our mayor,” he said, referring to Mayor Muriel Bowser.

“Our mayor was very wise, and she maximized the Affordable Care Act to make sure that everyone regardless of anybody's circumstance, could get health services in the District,” Taylor said. “I think there's a perception around East of the river that is not always the best, [whether it be that] people are poor, they can't pay, etc., but if you have Medicaid and if you are a practice, you should be taking Medicaid, [and] every type of insurance you can possibly take.”

With a large percentage of patients traveling to his former Northwest office for services, Taylor grew inspired to move the practice closer to the demographic they served most.

Metro Health, previously located on 14th Street, Northwest, moved to the Eastern Market neighborhood in Southeast, in January of this year, making their new location their main operating hub.

“I didn’t think we were centrally located to serve the people that really needed our services. That's along the shore,” Taylor said.

Assistance for health workers

Government assistance may be available to health workers who practice in a health professional shortage area.

Health Professional Loan Repayment Program (HPLRP), administered by the DC health department

Provides loan repayment to eligible health professionals practicing full-time at HPLRP-certified sites in health professional shortage and medically underserved areas.
Assists certified sites to recruit and retain providers by providing loan repayment up to $151,841.29 over four years for physicians and dentists and $83,510.61 for all other eligible providers.

Health Services Corps is a federal program administered by the Health Resources and Services Administration

Provides scholarships and loan repayment to healthcare professionals practicing at approved sites located in or serving health professional shortage areas, or HPSAs.
Federal funds are administered by DOH

Health Enterprise Zone Act of 2013, D.C. Council legislation

Referred to the Committee on Finance and Revenue, but no further action was taken.
Seeks to aid medical professionals who want to operate their practices East of the River and other officially designated areas that have a large number of residents who are in need of those services.
Included a $7,500 tax credit to medical practices in designated areas for 10 years and waive the 60-day waiting period for those firms needing “certificate of needs.”
Introduced by former D.C. Council members Marion S. Barry (D-Ward 8), Yvette Alexander (D-Ward 7) and Jack Evans (D-Ward 2) and current Council member Anita Bonds (D-At Large), the main sponsors of the bill. Co-sponsors: former Council member David Grosso (I-At Large) and current Council member Kenyan McDuffie (D-Ward 5).

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Freelance writers Lindiwe Vilakazi covers health news and James Wright reports on the local business community in Washington, D.C., and Prince George’s County, Maryland.

This article was made possible with funding from the Solutions Journalism Network and may be republished through the network’s story tracker.