Community leaders, interested in the changes brought by growth and change, requested this report to better understand the demographic, health access and health status of area residents.
Northwest Colorado is a largely rural area of the state that shares many of the same health care challenges experienced by rural communities throughout Colorado and the nation. At the same time, its demographic, geographic, and economic characteristics make it unique and in need of geographic-specific policy options to address identified health care access barriers.
A summary of the key findings and policy implications deriving from CHI’s analysis of available data:
While the five counties that comprise Northwest Colorado have experienced slower population growth over the past eight years compared to the rest of the state, this trend is projected to change over the next decade. Population growth rates will increase significantly, albeit unevenly among the five counties. Planners and policymakers will need to take these differential trends into consideration when evaluating community-based initiatives designed to increase access to care.
The older adult population (65 years and older) will grow over the next ten years in all counties, with notable growth occurring in Routt and Grand counties. Alternatively, the working age adult population will not grow at nearly the same rate, which could result in a health care workforce shortage if these trends materialize. The workforce shortage could be particularly problematic in the long-term care sector as it is largely comprised of a paraprofessional workforce that is characterized by low wage jobs that are likely insufficient to cover the costs of living in the relatively affluent counties of Northwest Colorado.
The projected growth in the older adult population will also challenge local health care systems as Medicare will be an increasingly major payer for both physician and hospital services. As the population ages, the likelihood of developing chronic disease increases which places different demands on the health care system than those required to care for children and working adults. Chronic care management is often provided by advanced practice nurses who increasingly assume these primary care roles as well as palliative care and end of life hospice care; therefore, attention to the nurse workforce will become particularly important in the future.
Compared to the rest of the state, some Northwest Colorado counties have relatively high enrollment of children in the Medicaid and CHP+ programs, but underutilized the funding available to health facilities in the Colorado Indigent Care Program (CICP). Although the new hospital fee bill that passed in the 2009 legislative session should ensure enhanced payment to all Colorado hospitals over time for indigent care, CICP funds could be more aggressively sought in the interim.
With the implementation of the 2009 Colorado Healthcare Affordability Act over the next several years, Medicaid and CHP+ caseloads are expected to increase significantly for both the child and adult populations through 2013. Addressing these increased demands on local health care resources will require a focused examination of current and future gaps in primary and specialty care throughout the region.
Rio Blanco and, to a lesser extent, Moffat counties have been cyclically affected by expansions and contractions of the natural gas industry. In the most recent industry boom, an influx of workers placed increased demands on existing health care services.