Bowie County

Low Income Primary Care Access

Summary of Information:

Low Income Population: 34,565 (at or below 200% FPL, 1998)

Total practicing primary care physicians: 53

Regular full time equivalency: 52.5

Full time equivalents serving the low-income population: 9.7

Ratio of low-income population to low-income FTE: 3,563:1

Considered a shortage of providers: Yes, submitted for Low-Income

HPSA designation 7/18/01.

Physicians accepting new patients: 93%

Physicians accepting new patients who have Medicaid coverage: 21%

Physicians who can provide interpretation for non-English speaking patients: 72%

Languages interpreted: Spanish, Korean

Community Input:

Health care services are focused in Texarkana, so transportation to services is a significant barrier. Preventive services are usually non-reimbursable, so they are not accessible to low-income or non-insured patients.

There is a lot of infighting with the two major hospital systems and reorganization leading to consumer confusion.

What are the barriers to health care for people in your county?

“None” -- response given by nine physician offices.

“Insurance, patients don’t know what is covered, what the co-pay is.”

“Transportation and money.”

“Not enough doctors that can take Medicare and Medicaid because of low reimbursement rates.”

“Income, limited number of physicians.”

Are there additional barriers for the low-income population?

“No” -- response given by nine physician offices.

“A lot of doctors won’t take Medicaid and Medicare.”

“Lack of education for patients about preventive care so problems become acute.”

“Not a lot of facilities that take Medicaid.”

“Transportation, but our office does provide transportation. Education-sometimes the patient cannot understand what the doctors are trying to convey to them.”

Prepared by Community Health Provider Resources, Texas Department of Health, as part of The Robert Wood Johnson Foundation East Texas Rural Access Program; Spring 2001