Last updated: December 23, 2015

Author: State Office of Rural Health & Primary Care

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Improving health care services includes increasing access to and use of evidence-based preventive services. Clinical preventive services are services that:

• Prevent illness by detecting early warning signs or symptoms before they develop into a disease (primary prevention).
• Detect a disease at an earlier, and often more treatable, stage (secondary prevention).

Visit: http://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services

Vermont does not currently collect information on this specific indicator. However, since all health insurance plans are required to cover most clinical preventive services, you may refer back to the indicators addressing insurance coverage for adults and children.

This indicator is part of Healthy Vermonters 2020 (the State Health Assessment) that documents the health status of Vermonters at the start of the decade and the population health indicators and goals that will guide the work of public health through 2020. Click here for more information.

Act 186 was passed by the Vermont Legislature in 2014 to quantify how well State government is working to achieve the population-level outcomes the Legislature sets for Vermont’s quality of life. It will assist the Legislature in determining how best to invest taxpayer dollars. The Vermont Department of Health and the Agency of Human Services report this information annually. Click here for more information.

Dept. of Vermont Health Access (DVHA) leads on this measure through Vermont Health Connect program and website, along with funded navigators & assistors at community and clinic sites.

• Vermont Coalition of Clinics of the Insured (VCCU) http://www.vtccu.org/
  • Bennington Free Clinic (Bennington, VT)
  • The Health Assistance Program at Fletcher Allen Health Care (Burlington, VT)
  • Good Neighbor Health Clinic / Red Logan Dental Clinic (White River Junction, VT)
  • Health Connections at Gifford Medical Center (Randolph, VT)
  • The Open Door Clinic (Middlebury, VT / Vergennes, VT)
  • People's Health and Wellness Clinic (Barre, VT)
  • Putney Walk-In Clinic (Putney, VT)
  • Rutland Free Clinic - Medical and Dental Clinics (Rutland, VT)
  • Valley Health Connections (Springfield, VT)
  • Windsor Community Clinic (Windsor, VT)
• Federally Qualified Health Centers (FQHCs) & Bi-State Primary Care Association(PCA)
  • Northern Tier Center for Health (NOTCH)
  • Community Health Services of Lamoille Valley (CHSLV)
  • Northern Counties Health Care (NCHC)
  • The Health Center (THC)
  • Little Rivers Health Center (LRHC)
  • Community Health Centers of Burlington (CHCB)
  • Community Health Centers of the Rutland Region (CHCRR)
  • Springfield Medical Care Systems (SMCS)
  • Mountain Health Center (MHC)
  • Gifford Health Care (GHC)
  • Battenkill Valley Health Center (BVHC)
  • Indian Stream Health Center (ISHC)

Other Vermont Health Connect Navigators & Assisters, funded by DVHA & Vermont HealthConnect.

Mandating insurance coverage; offering affordable/price-sensitive insurance plan options; helping people understand the requirements, benefits and options of various plans.

Having adequate health insurance coverage can reduce barriers to quality health care and may even improve an individual’s health. A key component of the Affordable Care Act (“Obamacare”) is that anyone with an insurance plan is now guaranteed access to many preventive services that were rarely covered under catastrophic health insurance plans of the past and very expensive if paid out of pocket.

A study of health outcomes after implementation of health care reform in Massachusetts, including health insurance mandate, found improvements in general health (1.7%), physical health (1.3%) and mental health (1.5%) among 345,000+ respondents. Significant improvements were also noted in the rates of preventive services like Pap smears (2.3%), colonoscopies (5.5%) and cholesterol testing (1.4%). Improvements in health status were greater among lower income households (<300% FPL). (Source: van der Wees, P.J., et al, Improvements in Health Status after Massachusetts Health Care Reform, The Milbank Quarterly, Vol. 91, No. 4, 2013 (pp. 663–689) Mass_Health_Care_Reform_Study.pdf

The Medicaid expansion and Vermont Health Connect has helped increase insurance coverage across income levels. Despite the largest decline in uninsured rates between 2012 and 2014 (6.9%), the adults in households at 100%-199% of Federal Poverty Level (FPL) still have the highest rate of uninsurance (5.3%). Mass_Health_Care_Reform_Study.pdf

DVHA operates Vermont HealthConnect, the ACA-funded online Health Insurance Exchange.DVHA also contracts with Federally Qualified Health Centers (FQHCs), Free Clinics and other provider practices to employ Navigators and Assistors to work with Vermonters enrolling and re-enrolling in commercial and publicly funded health insurance plans.

Vermont’s State Office of Rural Health & Primary Care (SORH/PCO) provides an annual grant to the Vermont Coalition of Clinics for the Uninsured (VCCU) to help support operations of 10 free clinics around the state.While some of these clinics provide free medical and/or dental care to uninsured patients, all clinics act as Navigators or Assistors to enroll uninsured Vermonters into insurance Medicaid or commercial health insurance plans through Vermont HealthConnect. This $680,000 annual grant to VCCU and its member clinics is funded out of Vermont’s 1115 Medicaid waiver, known as Global Commitment.

Data is updated as it becomes available and timing may vary by data source. For more information about this indicator, click here.