Routt County ranks high in statewide health access survey | SteamboatToday.com
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Routt County ranks high in statewide health access survey

STEAMBOAT SPRINGS — In a comprehensive survey on access to health care, Routt County ranks among the top 10 counties in the state, according to new data from the Colorado Health Institute.

The “2017 Access to Care Index” rates counties on a scale of one to 10, seeking through various data collection methodology to answer the question “Are Coloradans able to get affordable, efficient health care?”

Routt County’s score was 8.0, the same as Colorado’s overall score. It measured better than all its neighboring counties and saw its score grow by 6 percent from 2013.

The top spots went to Boulder and Douglas counties, with scores of 8.3, while Saguache County in the San Luis Valley landed at the bottom with a score of 6.2.

Across Colorado, while lower-income residents saw lower overall access to care scores than higher-income residents, the lower-income score increased from 2013 — the year before Medicaid expansion — while the higher income score remained steady.

Urban areas saw better access than rural areas, and scores were slightly lower for Hispanic Coloradans than white residents.

The study focused on 25 factors within three categories: “potential access,” “pathways” (or barriers) to care and “realized access.”

In terms of potential access, Colorado and Routt County saw a significant increase in the number of people covered by insurance with the 2010 Affordable Care Act and Medicaid expansion in 2014.

Stephanie Einfeld, CEO of the nonprofit Northwest Colorado Health, noted her organization led an “extremely successful” outreach effort to get people enrolled in coverage programs. The region saw the highest per capita enrollment rate in the state, she said,

The “potential access” score for Routt County, which also includes the number and availability of providers, was 8.2.

For “pathways to care,” which included affordability, transportation and being treated respectfully, scored 9.1.

But looking at the “realized access” category locally and statewide, “Colorado has not seen an increase in the use of health care, especially preventative care, which might have been expected with the rise in the number of insured Coloradans,” according to CHI senior policy and statistical analyst Emily Johnson. “This indicates that use of needed services has yet to catch up with increases in coverage, suggesting that educating Coloradans about how to navigate the system or the value of preventative care may need additional attention.”

Routt County’s “realized access” score, which included factors such as appropriate use of the emergency room, cancer screenings, prenatal and dental care and well-child visits, was the lowest score at just 6.8 (6.9 for Colorado).

Frank May, CEO of UCHealth Yampa Valley Medical Center, emphasized getting care “at the right point” — which can often be at the primary and proactive care points as opposed to ER visits — as one of the most important factors to improving access and overall health outcomes.

Preventative care is at the center of his organization’s mission, May said. Instead of just focusing on taking care of sick people, “It’s about reaching out and keeping people healthy,” he said. “And improving people’s knowledge of why they should be seeking preventative care.”

Last year, Einfeld said Northwest Colorado Health hired “community connectors,” both English and non-English speaking to increase their outreach and education efforts.

Even with a sufficient number of providers, “We still know there’s a population just not being served,” Einfeld said, “Especially in the outlying areas.”

Northwest seeks to “serve the entire population,” regardless of ability to pay, she said. “But in order to reach people we haven’t reached, we have to do something we haven’t done before.”

Acting as the public health department for Routt County gives Northwest Colorado Health more ability to “treat the whole person,” and offer more than a typical clinic, she said, acting as a “one-stop shop.”

They are also increasing walk-in and evening hours and working to integrate more dental services. Behavioral health care is one area in which “We don’t have enough services compared to the state,” she said.

Ken Rogers, district manager of South Routt Medical Center, also said mental and behavioral health care is an area they are always trying to increase but finding the existing local providers with whom they want to partner are often “tapped out.”

Rogers also emphasized the focus on oral health as health care, and their work to offer more dental care and referrals at their small, independent center located in Oak Creek.

Like Northwest Colorado Health, South Routt Medical Center offers payment options on a sliding scale and walk-in visits and works to “make services affordable to everyone who comes in,” Rogers said.

From 2013 to 2016, Rogers said they’ve seen their patient load double, with an annual increase of 10 to 12 percent. Twenty-eight percent of their patients come from outside South Routt, he noted.

Rogers also talked about working to increase outreach efforts, with plans to host monthly community talks on things like diabetes, alzheimer’s and dementia and women’s health.

They offer some transportation and house calls and are adding evening hours, he said, and are hoping to bring in more specialists like cardiologists and pediatric and geriatric doctors once a month.

Rogers points to the community as the reason South Routt has been able to keep their doors open, with a mill levy passed by voters in 2006 and increased in 2016.

“We are truly community based,” he said.

In terms of quality of care, Einfeld and May are both proud of their much larger regional organizations, which have received state and national recognition.

“For a community our size, we have a highly educated and talented staff,” May said, adding that UCHealth Yampa Valley Medical Center is ranked among the top 100 hospitals in the country.

And even as a community health center with a focus on an underserved population, “Our quality of care is top notch in the nation,” Einfeld said, “with higher positive outcomes.”

They both also commend collaboration between the region’s various health and community agencies to work toward the common goal of increasing access to health care.

So how has and can the CHI data be used on local levels?

A number of way, said CHI analyst Johnson, including, “informing local planning and decision making, launching conversations about health equity, advocacy for underserved populations, and grant writing.”

With data at the county level, it also gives opportunity for comparisons across the state, and the ability to measure disparities and changes over time.

More information can be found at: https://www.coloradohealthinstitute.org/research/2017-access-care-index.


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