HISTORY OF PROJECT ACCESS

Project Access began in Buncombe County, North Carolina in response to physician’s frustrations about the fragmented approach to providing health care to uninsured, low-income residents of the county.  The Buncombe County Medical Society spearheaded an effort with grant funding from the Robert Wood Johnson Foundation, beginning to involve the many community partners who eventually made Project Access a success.

The key to success was the initiative and commitment of the physician community.  Over 500 physicians agreed to provide donated care to Project Access patients.  The value of this care was enumerated to “leverage” donations from other partners in the community.

• County government officials agreed to allocate county indigent care funds to the project.

• The Buncombe County Health Center continued to be a major source of primary care for indigent patients, but also took on a major role in screening and enrolling Project Access patients.

• The Department of Social Services supplied out stationed eligibility workers to enroll patients.

• Hospitals agreed to accept and provide a full range of services for Project Access patients.

• Community-based indigent care clinics provided another access point to Project Access.  Some physician volunteers chose to see patients in those settings.

• County pharmacists agreed to waive part of their regular charges and filled prescriptions offered through the Project Access formulary.

• Mountain Area Health Education Center provided evaluation services.

• Mountain Health Care (an IPA) donated insurance claims tracking.

Project Access has enjoyed huge success in Buncombe County.  Of an estimated 15,000 uninsured, low-income residents of Buncombe County, nearly 13,000 have accessed primary care or specialty care, and over $3.5 million in donated care was documented.  The project attracted considerable attention within the state, nationally, and internationally, and won an Innovations in American Government award.  Former Vice-President Al Gore has praised it as a model on re-inventing government.  Governor Jim Hunt of North Carolina has expressed an interest in replicating it across North Carolina, and Dr. Marilyn Gaston, of the Bureau of Primary Health Care, would like to see it replicated across the country.