Mountain Counties with High Insurance Tabs also Short on Doctors

Map showing the ratio of population to full-time, primary care physicians in Colorado. (Map links to PDF of full report.)

Colorado Health Institute

Map showing the ratio of population to full-time, primary care physicians in Colorado. (Map links to PDF of full report.)

Don’t get sick if you live in Eagle, Pitkin or Garfield counties.

As you probably know, health insurance may be out of reach. At $483 a month for the cheapest silver plan offered on the state exchange, the region has the most expensive insurance rate in the nation, according to a recent analysis by Kaiser Health News.

But let’s say you can afford insurance, either because you qualify for a subsidy or you’re rich enough not to need one. That doesn’t mean you can find a doctor. In fact, your region also has one of the biggest ratios of patients to primary care providers, according to a recent study by the Colorado Health Institute.

Dylan Lewis, who is 36 years old and lives in Glenwood Springs, is among those people who’s obliged to remain well.

He and his wife run a small marketing firm, Lewis Marketing. The business brings in enough to pay the bills for their growing family, including a five-month-old daughter, and to bump them out of subsidy territory.

On Colorado’s health exchange, only two plans are accepted by doctors in their area. That leaves the family with this best bad option: A health plan with a roughly $1,000 premium and a $5,000 deductible.

Lewis doesn’t know what he’s going to do.

“Maybe if we can refinance the house,” he says. “Worst case scenario we can just pay for my wife and baby.”

Add to that insult the further injury of too few doctors. Garfield County, like its neighbors Eagle, Grand, Pitkin and Summit counties, needs to boost its roster of primary care physicians by 30 percent if it’s going to meet the needs of its population, according to the institute’s analysis.

The analysis used a benchmark of 1,900 people for every full-time doctor. The mountain resort regions weren’t the only ones that fell short of this standard. The worst-off region includes the counties of Cheyenne, Elbert, Kit Carson and Lincoln, which need to triple their doctors to meet the need. Even urban areas like El Paso and Douglas counties have shortages.

Rebecca Alderfer, the study’s lead author, said that at the root of this study were questions about what additional medical workforce would be needed as more Coloradans gain insurance. This was an attempt to gauge the current conditions across the state, with apples-to- apples comparisons of full-time physicians across counties.

Rebecca Alderfer

Rebecca Alderfer

Colorado Health Institute also looked at Medicaid capacity across the state, and found shortages in the number of doctors willing to take the public insurance. Denver, Adams and Arapahoe counties were among the places with a shortage of Medicaid providers.

Ross Brooks is executive director of Mountain Family Health Centers, a network of safety net clinics that operates across the resort areas with some of the worst doctor shortages. The centers now serve around 13,000 people, Brooks says, and that number is growing.

People sometimes assume that living near Aspen or Vail means that you’re rich, but that’s not true, says Brooks.

“There are lots of folks who are making food and making beds and working in the retail industry and hospitality industry,” he says, “and a lot of those folks are our patients.”

His clinics have a hard time finding doctors willing to work for a pay cut rather than taking a more lucrative position at a private practice.

The beauty of the area and the good skiing help attract some. But it’s not always enough – even for doctors who rely on private insurance.

Lewis, who runs the marketing firm, says his family doctor now has a two and a half month wait time for a routine appointment.

 

 

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