Mapping the Road to Health Care Access
New data reveals where Coloradans travel for care and how to strengthen rural health resources.
What if we could understand health care access not by static maps or administrative borders, but by the actual routes Coloradans take to receive care? With this understanding, we could focus investments in places where care is hardest to reach – where distance, cost, and other barriers keep people from getting the services they need.
A new initiative led by the Colorado Primary Care Office (PCO), in partnership with the Health Resources and Services Administration (HRSA) aims to do just this by using mapping and care data to inform where workforce resources are needed most. Supported by CIVHC and CO APCD Data, this project will transform how the state identifies Health Professional Shortage Areas (HPSAs).
Reimagining Access
For decades, HPSAs have been defined using methodologies developed in the 1970s, largely relying on county lines and other administrative boundaries. As PCO Director Steve Holloway says, “Few of us have ever considered a county boundary when determining where we or our families would receive care.” Instead, this project asks a simple but powerful question:
Where do Coloradans go for care and how can that inform smarter service area planning?
To answer that, the PCO is using claims-level data from the Colorado All Payer Claims Database (CO APCD) to analyze where people live and where they receive primary, dental, and mental health services. These origin-destination “travel maps” reveal natural service areas, shaped by geography, drive time, cultural identity, and socioeconomics. The goal is to build a comprehensive, data-informed Rational Service Area (RSA) plan that reflects how Coloradans choose and access care.
- In southwest Colorado, residents of Dolores and western San Miguel counties often receive care in Cortez (Montezuma County). A county-based model would separate these areas, masking a shared health care hub.
- In Crowley, Otero, and Bent counties, the town of La Junta emerged as the central care hub. However, some northern residents still travel to Pueblo—demonstrating how even small areas show variation.
By layering CO APCD claims data with census and social determinants indicators, the project can classify areas to be scored based on poverty, unemployment, public insurance enrollment, and number of children per household. Service areas are also evaluated for Ambulatory Care Sensitive Conditions (ACSCs), preventable health issues that often show up in emergency rooms due to inadequate primary care access.
This approach provides a deeper lens into need, helping the state prioritize investments not only where care is distant, but where social and economic barriers prevent people from accessing it, even if providers exist nearby.
A Path Forward
Whether it's a rural town in the San Luis Valley or a neighborhood in north Denver, these insights help make sure every community is seen, supported, and strengthened. With support from CIVHC and the analytical power of the CO APCD, the Colorado Primary Care Office is building a more responsive, realistic map of health care access and one based on the experiences of patients across the state.
As the project moves into its next phase, it will focus specifically on Medicaid-eligible clinicians and publicly insured patients. Since access is a frequent challenge for Medicaid patients, refining service area models with this consideration will help the state more fairly deploy publicly funded programs, like Medicaid incentives, Colorado Health Service Corps (CHSC) loan repayment, and targeted workforce expansion.
View Stephen Holloway's recorded presentation from our CO APCD Research Showcase
Additional Resources
If you’re a provider, payer, researcher, or community leader looking to better serve Coloradans, CIVHC can help. Through access to CO APCD data, analytic support, evaluation, and research services, we work with partners across the state to identify gaps, support better care, and reduce disparities.
Contact us at info@civhc.org
