A Dialogue about Grand Junction

Colorado’s very own Grand Junction was once again in the national spotlight in an analysis released last week by The Commonwealth Fund. The Scorecard on Local Health Performance evaluated local health care systems across the country on four dimensions:

1. Access and affordability

2. Prevention and treatment

3. Costs and potentially avoidable hospital use

4. Health outcomes

The report covered the nation and compiled data from a variety of sources. The findings reinforced the notion that where an individual lives is often indicative of his or her ability to access needed health care, as well as the quality and cost of care received. Grand Junction, which is highlighted in the report, has received much press over the past two years about its successes in reforming the way health care is coordinated and delivered.

Grand Junction (and its surrounding area) scored within the top ten percent on costs/potentially avoidable hospital use and relatively high on prevention and health outcomes. These findings are generally consistent with Colorado-specific resources such as the 2011 Colorado Health Access Survey (CHAS). (Of note, the Commonwealth Fund report also highlighted Boulder for scoring in the top ten percent on the latter two dimensions).

In addition to Grand Junction’s successes, what also caught my eye was that the very same area scored in the bottom quartile on access and affordability.

Granted, this dimension was calculated based on only five indicators: insurance rates among adults and children, adults receiving a routine checkup, adults reporting no cost-related problems in seeing a doctor and dental visits among adults. Nonetheless, these are important indicators and I began to think through what the story might be.

Is it that the region surrounding Grand Junction includes communities where access is poorer? Are there socioeconomic or demographic differences that account for the higher uninsured rates? Perhaps the underlying adult population is healthier? Perhaps most uninsured adults and children are receiving the care they need through a robust safety net?

I am interested in learning from you. For those of you out there living in Grand Junction or Boulder (or just interested in the topic) – what was your reaction to the findings? What factors do you believe are reflected in the data?

Postscript: Tomorrow, March 22 at 8:00 am, Colorado’s own annual scorecard, the 2011 Colorado Health Report Card, will be unveiled by The Colorado Health Foundation. The Colorado Health Report Card, in contrast to the Commonwealth Fund’s report, compares Colorado’s performance on 38 health indicators to the other 49 states. Stay tuned to Analysis with Altitude for more information!

Jeff Bontrager is the director of research on coverage and access at CHI.