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Healthcare Access in Western North Carolina: What Might 2014 Hold?

Healthcare Access in Western North Carolina: What Might 2014 Hold?. Amy Marietta, MPH Larry A. Green Visiting Scholar Robert Graham Center March 20, 2012. Objectives. Present overview of demographic profile of WNC

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Healthcare Access in Western North Carolina: What Might 2014 Hold?

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  1. Healthcare Access in Western North Carolina: What Might 2014 Hold? Amy Marietta, MPH Larry A. Green Visiting Scholar Robert Graham Center March 20, 2012

  2. Objectives • Present overview of demographic profile of WNC • Describe some characteristics of the healthcare workforce in WNC, focusing on access to primary care • Identify current healthcare infrastructure in WNC, focusing on federally-funded sites • Present an idea of some challenges that WNC may face in 2014 with the changes in Medicaid enrollment

  3. Where’s Western North Carolina? Section 1

  4. Western North Carolina

  5. Section 1: Demographics State: 31.5% non-White 8.4% Hispanic WNC: 12% non-White 5.6% Hispanic Fig 1. Percent Population Hispanic (Census 2010) Fig 2. Percent of Population non-White (Census 2010)

  6. Section 1: Demographics State: 14.8% Poverty 34.6% Low-Income WNC: 14.7% Poverty 36.8% Low-Income Fig 1.3. Percent Population <100% FPL (ACS 2005-2009) Fig 1.4. Percent of Population <200% FPL (ACS 2005-2009)

  7. State: 12.7% age >65 19% uninsured WNC: 19.3% age >65 20.45% uninsured Section 1: Demographics Percent of Population Age 65 or Older Fig 1.5. Percent Population Age >65 (ACS 2005-2009) Percent of Population Uninsured Fig 6. Percent of Population Uninsured (SAHIE 2007)

  8. Healthcare Workforce Section 2

  9. Section 2: Healthcare Workforce Fig 2.1. Number of Primary Care Physicians, by county (AMA) Fig 2.2. Primary Care Physicians per 10,000 persons (AMA)

  10. Figure 2.3 Primary Care MD per 10,000 people, by county (Sheps Center) Figure 2.4 Primary Care MD per 10,000 people, by county (AMA)

  11. Figure 2.5 Primary Care MD per 10,000 people, by county (Sheps Center) Figure 2.6 Primary Care MD per 10,000 people, by county (AMA)

  12. Figure 2.7 WNC Health Professional Shortage Areas

  13. Figure 2.8 WNC Loan Repayment and National Health Service Corps Scholar Sites

  14. Figure 2.9 Medicaid-accepting Sites in Western North Carolina. Includes private practices, health centers, clinics, and hospitals. (CCNC 2010)

  15. Healthcare Infrastructure Section 3

  16. Figure 3.1 Access points in WNC

  17. Figure 3.2 All Grantee Penetration of Low Income Population (<200% of FPL)

  18. The Future- What Does 2014 Hold? Section 4

  19. Figure 4.1 Percentage of the Nonelderly Population With Income Up to Four Times the Poverty Level Who Were Uninsured or Purchasing Individual Coverage, 2010

  20. Figure 4.2. NC SuperPUMAS • 14 SuperPUMAs in North Carolina • Each Comprised of 2-6 PUMAs • Based on Census Tracts • 1 PUMA = approx 100,000 people • WNC split between 2 SuperPUMAs and 6 PUMAS

  21. Figure 4.3 Western North Carolina PUMAs

  22. Table 4.1 Percent of population newly eligible for Medicaid in 2014 by PUMA and age

  23. Conclusions • WNC is less non-white and less Hispanic than state as a whole • WNC has a larger aging and uninsured population than state as a whole • Overall the provider-to-population ratios for primary care are higher in WNC than states as a whole, with the exception of Clay, Graham, McDowell, Madison, Rutherford counties. • Even in counties with a high provider-to-population ratio, there may be very few Medicaid-accepting sites (i.e. Swain county)

  24. Conclusions, cont. • Federally-funded primary care sites are not necessarily located in counties most in need of primary care providers, and penetration of low-income population by federal sites is low. • Far western NC and the Appalachian region is likely to experience an increased demand for healthcare services as a large percentage of the population becomes newly eligible for Medicaid and health insurance tax credits in 2014.

  25. Next Steps • Report to CEOs MAHEC, Mission Hosp. • Connect to health outcomes data from CCNC • Connect to cost data from Medicaid claims • Identify Medicaid sites’ FTE, patient panels, accepting new pts, etc. to assess true capacity • Identify other “shortage specialties” in addition to primary care- psychiatry, general surgery, etc. • Present information to stakeholders • Develop regional plan for 2014

  26. Thanks! Questions? amy.marietta@gmail.com

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