Smith County
Low
Income Primary Care Access
Summary
of Information:
Low
Income Population: 61,912 (at or below 200% FPL, 1998)
Total
practicing primary care physicians: 166
(including residents)
Regular
full time equivalency: 148
Full
time equivalents serving the low-income population: 31.8
Ratio
of low-income population to low-income FTE:
1,947:1
Considered
a shortage of providers: No, not
whole county. However,
census
tracts 1, 2, 2.01, 3, 4, 5, & 6 were designated 9/11/01.
Physicians
accepting new patients: 70%
Physicians
accepting new patients who have Medicaid coverage: 59%
Community Input:
Education,
availability of physicians who are or can see indigent patients and/or
Medicaid patients is low. Language
and lack of knowledge by the public of who can provide services are also
barriers. There is no mental health
care if the patient has no insurance.
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Physicians
who can provide interpretation for non-English speaking patients: 33%
Languages
interpreted: Spanish
What
are the barriers to health care for people in your county?
“No
barriers.” -- response given by 12
physician offices.
“Trouble
getting medications for elderly, the affordability of meds.”
“Language
barriers and transportation.”
“The
elderly can only afford Medicare.”
“Language,
transportation, education.”
“The
referral process is too ‘paperwork intensive’.”
“PPO
insurance coverage limits where folks can go.”
“The
health care here is very big, with lots of indigent and Medicaid providers.”
“Managed
care has ruined things…too many patients per doctor.”
“Insurance issues—not having it and too much
red tape involved.”
“Lack
of freedom of physician choice because some doctors are full.”
“Not
having someone to translate for Hispanic patients. Staffing, there is lots of
turnover due to low pay. Insurance companies keep changing the rules and people
don’t know what’s covered. Referral process is too long, voice automated
system. Insurance companies only allow people to go to one or the other
(Trinity Mother Frances or Medical Center) . . . no choice in the matter.”
“No
affordable health plans for children and the elderly. Transportation, especially in bad weather.”
Are
there additional barriers for the low-income population?
“No
barriers.” -- response given by 10 physician offices.
“Working
poor don’t qualify for Medicaid. Also, no green card means trouble getting
seen. However, the Trinity Mother Frances has a clinic for the poor.”
“There
are very few doctors who see Medicaid because of low reimbursement.”
“A
lot of doctors are not accepting new patients or do not take Medicaid or some
insurances.”
“Unsure,
we refer to clinic on Glenwood.”
“Not enough doctors taking Medicaid, not
taking CHIP patients.”
“St.
Paul has an indigent program that serves everyone.”
“There
are quite a few clinics here that see indigent and Medicaid patients, so I
don’t see much of a problem.”
“The
payment for people who do not qualify for Medicaid; and it’s a problem for
folks on a sliding fee scale to come up with cash.”
“Doctors
don’t take Medicaid.”
“People
won’t pursue health care because of the cost.”
“They
may have to pay up front because of no insurance.”