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 2015 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 (2011-2015). 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 online at

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 year (-24%), with more people being covered through both commercial and public insurance.
  • Although the overall number of individuals served through the St. Louis safety net system has remained stable, there has been a shift in the payor mix of these organizations.
  • While total emergency department visits increased by 5% in 2015, the number of uninsured emergency department visits declined by 11% between 2014 and 2015.
  • Behavioral health encounters continued to rise at area emergency departments in 2015 (+11%), while inpatient psychiatric capacity continued to decline (-5%). Volumes at community mental health centers remained stable, with variation seen in the rate of service across different parts of the “Eastern Region”.

Download the full report to learn more and contact Rikki Takeyama ( to schedule a presentation about the status of our healthcare safety net.