The St. Louis Regional Health Commission (RHC) is a collaborative effort of St. Louis City, St. Louis County, the state of Missouri, health providers and community members to improve the health of uninsured citizens in St. Louis City and County. As part of this effort, the RHC produces an annual “Access to Care” data book that reviews community-wide progress toward strengthening the primary, specialty, emergency care and behavioral health safety net system in the region. This report is a vital tool for many in our community to understand the local health care system. This year’s data book also reviews utilization volumes and outcomes from the 2016 calendar year of the Gateway to Better Health Pilot Program.
Access to Care provides a survey of annual operating statistics from primary, specialty, emergency care and behavioral health safety net health care provider institutions in the region. This year’s analysis focuses primarily on data reported over the past five years (2012-2016). Data for more recent calendar years, such as hours of operations and appointment availability for regional safety net provider institutions, is included when available. A summary of common themes and key findings is included below. The complete report is available here.
Below are some common themes found in the data across the different safety net care settings:
- The overall rate of uninsured has declined in St. Louis City and County over the past five years (-19%), with more people being covered through both commercial and public insurance.
- There has been a shift in the overall payor mix of St. Louis safety net organizations, with private encounters increasing and uninsured encounters decreasing or remaining stable.
- Wait times across both primary care and specialty care safety net sites have lengthened over the past year.
- Safety net primary care providers have greatly expanded their capacity to service the behavioral health needs of their patient populations (+52% in encounters over the past year). Volumes served at community mental health centers remained stable over the past year, with variation seen in the rate of service across different parts of the “Eastern Region”.
- Volumes of behavioral health encounters at area emergency departments decreased over the past year (-16%). While overall capacity for inpatient psychiatric services increased (+5%), total acute psychiatric encounters remained stable.