How much do West Virginia hospitals receive beyond Medicaid’s base rates? In Follow the Money: How West Virginia Finances Its Hospitals, Jessica Dobrinsky explains the financing structure behind additional hospital payments, including up to $1.34 billion authorized by CMS for FY2025, and calls for clearer public reporting of what individual hospitals receive.

Healthcare in West Virginia Healthcare policy is complicated. These resources make it understandable. If you are trying to make sense of West Virginia’s latest healthcare debates, you are not alone. The 340B drug pricing program, PBM regulation, PEIA’s recurring funding crises, and Certificate of Need laws all affect what care costs, where it is available, […]

West Virginia’s largest non-profit hospital systems hold three public protections from competition: they pay no income, property, or sales tax; Certificate of Need law blocks new competitors; and the federal 340B program lets them buy drugs at deep discounts and bill insurers at full price. A new Cardinal Institute paper by Jessica Dobrinsky asks a […]

West Virginia runs one of the most restrictive Certificate of Need regimes in the country, and the fight over it has been almost entirely about hospitals. A new Cardinal Institute paper by Jessica Dobrinsky shifts the lens to the services that rarely make the debate: hospice, nursing homes, and home health. The stakes there are […]

Charity Care West Virginia non-profit hospitals enjoy billions in tax exemptions. In return, the social contract demands they provide meaningful charity care to struggling families. The data shows they are not holding up their end of the bargain. This brief examines the evidence — from IRS filings, Medicare cost reports, and federal subsidy data — […]

Regulatory Reform in West Virginia The Problem: A State Buried in Red Tape West Virginia has accumulated one of the heaviest regulatory burdens in the nation. According to the State RegData project, the state now has 131,007 regulatory restrictions on the books — mandatory rules containing language like “shall,” “must,” and “may not” that impose […]

Special Circumstance Reviews Between 2023 and 2025, the West Virginia Board of Education launched nine Special Circumstance Reviews — structured state investigations into county school systems exhibiting signs of serious failure. These reviews, grounded in WV Code §18-2E-5 and WVBE Policy 2322, culminated in state takeovers of multiple districts. Taken together, they reveal not a […]

One Door to Opportunity West Virginia’s public assistance programs are scattered across a labyrinth of agencies, offices, and caseworkers — leaving struggling families to navigate a fragmented system at the worst possible time. This brief makes the case for a “One Door” approach: integrating workforce and social services into a single, streamlined department, modeled on […]

From Prison to Profession Shawn Tackett, a resident of West Virginia who had spent ten years in federal prison, faced difficulties adjusting to life on the outside. Although he had earned various trade certificates during his time in prison, his criminal record deterred employers from hiring him for jobs in those fields. Moreover, since he […]

Civil Society as the Middle Ground During the recent government shutdown, tensions rose for everyday Americans across the socioeconomic spectrum. Furloughed government workers wondered how they’d pay the bills while receiving no pay. Individuals and families leaning on Supplemental Nutrition Assistance Program (SNAP) benefits worried about how they’d keep food on the table when payments […]