Health leader talks Indiana’s low health care ranking, new system
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As the state’s public health sits low in rankings, an Indianapolis health care leader says community health centers are a way forward to instill an ability for Hoosiers to attain financially achievable medical and preventive care and reverse the state’s public health trajectory.
Indiana sits 43rd in national health care rankings, according to U.S. News & World Report’s 2023 report. While sitting centrally at No. 29 overall, medical care and public health are sore spots. A breakdown of the larger health assessment leave the state at 39th for health care access and 41st in both health care quality and public health.
Public health in Indiana
A major factor is the national trend of Americans being unable to pay for doctor visits and lacking access to primary care services. A recent study said 38% of Americans put off going to the doctor for financial reasons and are over twice as likely to say that delayed treatment was for a serious condition rather than a less pressing issue.
Chronic diseases are also the most costly and a widespread issue in the state and nation, the Indiana Department of Health said on its website. It continues to say those conditions and diseases are preventable and controllable through early detection, treatment and lifestyle changes.
The health department lists heart disease, cancer and respiratory diseases — consistent with national trends — as the top causes of death for Hoosiers. They attributed a considerable number of cases being related to 34% of Hoosiers being overweight and tobacco use.
The latter is another significant concern for the state. Indiana has the seventh-highest rate of adult smokers, and 21% of Hoosiers smoke compared to the national average of 14%. Nicotine use is also trending younger with the prevalence of vaping. One in five high schools and one in 10 middle schoolers use a tobacco product, according to 2018 state data.
And of course, the pandemic had a significant effect as well for a multitude of reasons.
A community-oriented approach to health care
Local public health leader Marc Hackett wants to address those public health issues and provide a health care experience that meets people where they are. Hackett has led in the realm of community health as the current CEO of the Jane Pauley Community Health Center as well as his previous roles as founder and executive director of the Windrose Health Network and executive director of the Shalom Health Care Center.
He said a culmination of reasons likely are the source for low national ranking. He mentioned widespread tobacco use, the overuse and misuse emergency rooms, inability to access affordable care and the lack of knowledge of health care options.
“There’s a lot of folks that really can’t even afford their health care — they’re uninsured or under-insured,” he said. “This community health center model that we’re part of, we see patients regardless their ability to pay.”
Hackett is a huge proponent of Federally Qualified Health Centers, which he sees as a bi-partisan supported way forward to improve public health across the state. They operate off federal funding, state health department funding and several grants. There are dozens throughout the state; 10 of which are Jane Pauley centers in Marion, Madison, Shelby and Hancock Counties.
At Jane Pauley Community Health Center, health care costs are calculated based off household income and patients could pay as low as $20 for a visit. They don’t send unpaid bills to collections either, Hackett said. They take all forms of insurance with a focus on those under Medicaid, which accounts for around a quarter of the state’s residents and 65% of the center’s patients.
Hackett talks mental and behavioral health care assistance at the Jane Pauley Community Health Center.
The center provides a variety of medical services such as primary care, behavior and mental health assistance and dental at some locations. Hackett said they keep an eye on overall health and well-being, including referring people to find help for mental illness, providing all-day bus passes to get to appointments and run errands, and offering food pantries at each location. They also provide language translation assistance, financial advocates and at-home blood pressure kits for providers to keep watch on patients.
They partner with other community health centers, food pantries and resource organizations, schools and the state health department, showing how public health is a community effort, Hackett said.
“I hate the tagline that I hear a lot from patients when they come in that we’re ‘the best kept secret in town,'” Hackett said. “We don’t want to be the best kept secret.”
Hackett believes this model is a way forward and said the centers have the ability to change people’s lives by establishing consistent health care and addressing a relationship with individuals and their community. The 10 centers in four counties had at least 26,000 unique patients and 100,000 total visits last year.
Through a new marketing push, Hackett said they hope to improve public knowledge of their community health centers and how the model works to the greater public and especially those who need it.
“We’re trying to take those barriers out, so they’re coming in and getting the preventive care that they need so they’re not waiting until it’s too late,” he said.