Connecting the Dots Between Health Care Access and . . . Gymnastics?

If access to care were an Olympic sport, Colorado would score a 7.9, according to the Colorado Health Institute’s newly updated Colorado Access to Care Index

This score has improved slightly since implementation of the Affordable Care Act (ACA), but perhaps not as much as some would have anticipated.

Obtaining needed health care is a complicated endeavor for many Coloradans. Much like gymnasts who must navigate a variety of barriers challenging their movement and balance, vulnerable Coloradans must navigate a variety of factors necessary to access health care: having adequate health insurance, finding a doctor, securing transportation and child care, taking time off of work.

And there are still no guarantees that you’ll get the care you need.

The Colorado Access to Care Index considers these factors — and more — and summarizes them on a scale of one to 10. The Colorado Health Institute, in partnership with the Colorado Coalition for the Medically Underserved (CCMU), developed the index to provide communities a tool to explore access issues over time.

We released the index earlier this year primarily using 2013 data. The 2013 information provided a baseline against which to monitor the impact of policy decisions such as the implementation of key ACA provisions or state decisions such as expanding dental coverage to adult enrollees in Medicaid.

What do the results tell us?

Overall, comparing the index over time suggests that Colorado is moving in the right direction. The score moved from 7.7 to 7.9. The beauty of the index, however, is the ability to dig deeper into the data to figure out the story.

For example, the score of 7.9 is based on three subscores, also on a scale of one to 10: Potential Access, Barriers to Care and Realized Access. Think of these three as Olympic judges. Instead of France, Canada and Turkey, however, they represent major dimensions of access to care.

Take the Potential Access score, for example. This judge considers factors that tend to promote access to care: having insurance, being adequately insured, having a doctor or other provider in the community. 

It turns out that much of the upturn in the overall score had to do with improvements in the Potential Access score – from 7.4 to 7.8. More specifically, this improvement was driven by Colorado’s uninsured rate falling from 14.3 percent in 2013 to 6.7 percent in 2015.

Access to care is improving for most regions of the state. The index also reveals that disparities across income and ethnic groups that predated the ACA still exist today, although income disparities are a bit smaller. You can find Access to Care Index scores for communities across Colorado here.

We plan to explore these disparities. And stay tuned for the Children’s Access to Care Index. We are excited to work with communities to understand why they received the scores that they did.

And most importantly, what they can do to improve. 

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