January 2013

Access to Health Services

Health insurance status is a key determinant of an individual’s access to health services. Uninsured and inconsistently insured people are less likely to receive needed medical care.¹ Health insurance coverage helps patients get into the health care system, get the care they need, and establish an ongoing source of care. People without medical insurance are more likely to lack a usual source of medical care as well as a primary care provider. Individuals who lack health insurance also receive less timely care and fewer health services overall, including fewer dental visits, immunizations, and routine cancer screenings. Consequently, uninsured individuals are more likely to have unmet health needs and worse health outcomes than their counterparts.^2,3 Despite these health impacts, in 2011 approximately 17% (46 million) American children and adults under age 65 reported not having medical insurance. Nearly 1 in 5 Americans of all ages did not have medical insurance for at least part of the year.⁴

Leading Health Indicators

Leading Health Indicators (LHIs) are critical health issues that—if tackled appropriately—will dramatically reduce the leading causes of death and preventable illnesses. The LHIs for Access to Health Services are:

• Persons with medical insurance
• Persons with a usual primary care provider

Where We’ve Been and Where We’re Going

Over the past decade, the rate of persons under age 65 with health insurance has decreased 1.0%, from 83.6% in 2001 to 82.8% in 2011. The proportion of persons with a usual primary care provider also decreased, moving from 78.2% in 2000 to 76.8% in 2010, although this change was not statistically significant. Differences in rates of health insurance exist by race and ethnicity and level of educational attainment. Differences also are observed in the proportion of persons with a usual primary care provider by race and ethnicity, level of educational attainment, and type of insurance.

Who’s Leading the Leading Health Indicators?

Securing Health Coverage for Children Through Statewide Partnerships

#LHI Twitter Chat: Access to Health Services   

You’re invited to @GoHealthyPeople’s first monthly LHI Twitter chat on Wednesday, January 30, 2013, from 12 to 12:45 PM EST. Join @HHS_DrKoh, @AHRQNews, and other special guests in discussing the topic of access to health services further. Follow along using the hashtag #LHI.

Related Resources

Health System Measurement Project Agency for Healthcare Research and Quality, Health Insurance/Access to Care Kaiser Family Foundation, Health Coverage & the Uninsured  Health Resources and Services Administration, Primary Care: The Health Center Program

Agency for Healthcare Research and Quality, Patient Centered Medical Home Resource Center InsureKidsNow.gov HealthCare.gov

Healthy People serves as the foundation for prevention efforts across the U.S. Department of Health and Human Services (HHS). Learn more about HHS prevention strategies.

¹ Office of the Assistant Secretary of Planning and Evaluation, U.S. Department of Health and Human Services. Coverage. Health System Measurement Project. [Internet] Available from: https://healthmeasures.aspe.hhs.gov/topic/C

² Institute of Medicine (IOM). America’s uninsured crisis: Consequences for health and health care. Washington: IOM; 2009.

³ Bovbjerg RR, Hadley J. Why health insurance is important. Health Policy Briefs. Washington, DC: The Urban Institute; 2007.

⁴ Cohen RA, Martinez ME. Health insurance coverage: Early release estimates from the National Health Interview Survey, 2011. [Internet] Hyattsville, MD: Centers for Disease Control and Prevention, National Center for Health Statistics; 2012 Jun 6. Available from: http://www.cdc.gov/nchs/data/nhis/earlyrelease/Insur201206.pdf [PDF - 516KB]

⁵ Kaiser Commission on Medicaid and the Uninsured. Health coverage of children: The role of Medicaid and SCHIP. Menlo Park, CA: Henry J. Kaiser Family Foundation; 2008.

⁶ Guerra-Cardus L. Child health coverage in 2012 and beyond. Houston, TX: Children’s Defense Fund-Texas; 2012.

Reference in this bulletin to any specific product, process, service, organization, or company does not constitute its endorsement or recommendation by the U.S. Government or the U.S. Department of Health and Human Services.