Wall Street Journal Examines Community Health Care for the Uninsured Through Project Access

The Wall Street Journal on Dec. 24 examined the American Project Access Network, a "grass-roots" program that provides health services, including diagnostic tests and prescription drugs, to low-income, indigent patients with a "pressing health need." The goal of the program, which began in Asheville, N.C., in 1996 and has been copied by more than 20 communities, is to reduce the number of uninsured patients who receive health services through emergency rooms, the Journal reports. Under the program, local physicians and specialists agree to provide free care to 10 to 15 patients annually. Participating physicians may then refer the patients to specialists if further tests and treatments are needed. The program also works with major pharmaceutical companies to get free drugs for patients and employs a full-time pharmacy benefits manager to track each patient's medication needs; patients generally pay $5 for each prescription. To qualify for the program, patients must have an immediate health need, lack health insurance and have an income of no more than 135% of the federal poverty level, approximately $966 a month for an individual. Patients must re-apply for the program every six months and can be dropped if they obtain employer-sponsored health care, if they qualify for Medicaid or another public program or if their health problem is resolved. Patients may also be dropped from the program if they miss two or more appointments without notice. According to Alan McKenzie, president of the network, the program helps physicians by limiting the number of uninsured patients they see. While funding and rates of success vary according by community, the original program in Asheville has helped approximately 90% of the low-income uninsured population there receive health care. About 40 communities are considering adopting the Project Access model (Carrns, Wall Street Journal, 12/24).