Access to Health Care: Experiences and Views of Communities in Lewis & Clark County



The Universal Access to Health Care Task Force conducted nine focus groups with community members across Lewis & Clark County to assess the health needs of community members and collect their suggestions for improving access to care. NESRI helped prepare this in-depth research report on participants’ views and experiences.

Headline findings:

  • Availability of health care:  Residents generally felt there was a shortage of service providers in the county.  Rural residents felt this particularly acutely. Low income residents also had difficulty finding health care providers, but higher income residents had less difficulty, with the partial exception of in-county mental health services.
  • Access (Cost):  Most participants – particularly low-income and middle-income residents – have experienced difficulty finding health insurance, using the insurance they have, or paying out-of-pocket.
  • Quality:  There were many positive statements regarding quality of care, particularly regarding the Lincoln Clinic. However, across the board there were serious quality concerns about some aspects of care, particularly related to St Peter’s Hospital.
  • Acceptability/Dignity:  Concerns about dignity in accessing and receiving health services were raised by low-income residents – particularly the uninsured and those on Medicaid – as well as residents seeking long-term mental health care
  • The Human Right to Health Care:  The majority of participants considered health care to be a human right. Several others emphasized ethical obligations to meet health care needs, but did not feel comfortable expressing that in human rights terms. Many participants stressed that to have a healthy community, the government or the local community should help everybody to be as healthy as possible.
  • Suggestions for reform:  Participants offered a range of suggestions for Lewis & Clark County, including expanding health care services, particularly primary care, improving care coordination, improving the navigability of the health system, improving transportation, and expanding financing options.

Additional Resources

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