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Show Health Care Plan Enrollment According to the Utah Association of Health Care Providers, more than half (56.3%) of all Utahns were enrolled in managed care plans in 1996. Managed care includes both health maintenance organizations (HMOs) and preferred provider organizations (PPOs). Traditional indemnity plans covered only 12.9% of Utahns; 9.3% of Utahns were uninsured, while the remainder utilized Medicare or Medicaid. Table 110. Utah Enrollment, As of January 31,1997 % of Utah Type of Plan Population Managed Care: HMOs 39.2 Managed Care: PPOs 17.1 Indemnity/Other 12.9 Medicare: Non Managed 8.7 Medicaid: Non Managed 1.8 Uninsured 9.3 Figure 61 Table 110. Source: 1997: Utah Association of Health Care Providers (1997). Facts About Health Systems and Hospitals 1996. Salt Lake City:, p.38-39. 1995: Utah Association of Healthcare Providers (August 1995). HMO and PPO Enrollment in Utah. Unpublished report. Prepared from data from the Utah Department of Health. Health Care Financing Administration. Salt Lake City:. Health Care Plan Enrollment in Utah, January 1997 50 T 40 -- Percent of 30 -- Utah Population20 -- 10 -- 0 -- 2 -8 2 -5 Health Professional Shortage Areas The term "Health Professional Shortage Area" (HPSA) is an official government designation1 put in place to identify and assist medically underserved areas. A HPSA may cover a portion of a county, an entire county or a group of counties. Criteria have been put in place to identify HPSAs. One criterion has to do with unusually high needs. High birth rates (greater than 100 births per 1,000 women age 15-44), high infant mortality rates (greater than 20 per 100 live births), and/or more than 20% of a population living in poverty would indicate a potential health professional shortages. Another criterion considers insufficient capacity of existing providers. This includes factors such as the number of visits per year per full-time provider, excessive use of the emergency room, and long waits to see physicians. Finally, the ratio of physicians to the population is considered in light of the criteria listed above. Level 1 HPSAs have more than 5,000 residents per physician, if they have a physician. Level 4 HPSAs have a ratio closer to 3,500 residents per physician. The other two levels fall in between. The HPSA maps for Utah and the U.S. break down the criteria into full or whole counties, part or partial counties and none or not designated counties. Full or whole counties are shown to illustrate a high shortage of physicians, part or partial counties are shown to illustrate a lower shortage of physicians. Finally, none or not designated counties show no shortage of physicians. In Utah, the majority of the population lives along the Wasatch Front. The remainder of the population is dispersed over 96% of the state's land area. Because of this disparity in Utah's population density, 25 of 29 counties in Utah qualify, at least in part, as Health Professional Shortage Areas. Utah's shortage of health care providers may impact other issues related to access, cost, and quality that are discussed in this section of the Review. Department of Health Division of Health Systems Improvement Bureau of Primary Care and Rural Health Systems, 1995. Professional Shortage Area Designation Criteria. Salt Lake City: Author. 139 |