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Key Issues / Safety Net / 2010 Colorado Safety Net Specialty Care Assessment: Final Report

2010 Colorado Safety Net Specialty Care Assessment: Final Report

March 1, 2011

An assessment of the availability of specialty care and best practices in the health care safety net through a statewide survey. Kaiser Permanente Colorado partnered with the Colorado Health Institute (CHI) in 2010 to develop the Colorado Safety Net Specialty Care Assessment, a document that examines the specialty care access gap faced by the safety net using both quantitative and qualitative means.

The assessment examined the availability of specialty care and best practices in the health care safety net through a statewide survey.

Overall, the survey results revealed that securing specialty care referrals for patients within Colorado’s health care safety net system is difficult, inconsistent and often futile.

Most safety net clinics offer specialty services on site but may be limited to just a few types

Two-thirds of responding clinics indicated that they provide specialty services on site, but the data suggest they offer only a few types of care.

 Most primary care clinics are likely not equipped or staffed to offer services such as vascular surgery or audiology. This fact is reflected in the numbers of clinics responding that they don’t offer most specialty services at their facility. Most clinics indicated they provide on-site mental health and dental services, which is beneficial; these services are not always easy to secure when clinics must refer patients, especially those who lack insurance coverage, to outside providers.

Safety net clinics indicated major barriers and greater difficulty in securing specialty referrals for their uninsured patients than for patients covered by public or private insurance. Moreover, the type of health insurance influences the difficulty safety net providers have in referring for specialty care. Findings suggest that the challenges in securing referrals for specialty care decrease as one moves down the following list of insurance types (from hardest to easiest): Uninsured; Medicaid; Medicare; Privately insured.

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