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Project Access WHO WE ARE Project Access coordinates access to healthcare for the low-income, uninsured residents of Sedgwick County, Kansas. The Central Plains Regional Health Care Foundation (a non-profit organization) oversees program operations. Project Access is comprised of participating doctors, hospitals, pharmacists and other ancillary medical providers who donate their services for eligible patients. The program is coordinated through partnerships with the Medical Society of Sedgwick County and it’s physician members, hospital systems, six indigent care clinics, twelve residency programs, Kansas Social and Rehabilitation Services (SRS), and sixty-nine pharmacies. The program is sustained through funding and in-kind contributions from the Medical Society of Sedgwick County, SRS, three hospital systems, the United Way of the Plains, the Kansas Health Foundation, the Wichita City Council and Sedgwick County Commission, the Robert Wood Johnson Foundation, the federal HRSA Community Access Program and other donors.
HOW WE BEGAN Project Access opened its doors September 1, 1999, culminating the vision and initiative of Paul Uhlig, MD and many diverse community leaders. As founder of the Project Access program in Wichita, Dr. Uhlig led discussions with local healthcare, government and social service leaders to explore the needs of the uninsured in Sedgwick County, and develop a plan to better coordinate access and maximize outcomes. Dr. Uhlig learned about the first Project Access program developed by the Buncombe County Medical Society in Asheville, North Carolina. He and local leaders traveled to Asheville to see first hand their successful Project Access program, and returned home to implement it in Wichita, which became the fist replication site for the Project Access model. It continues to receive immeasurable support and guidance from the Medical Society of Sedgwick County, its physician members, and its community partners.
WHAT WE DO Repositioned SRS eligibility specialists enroll patients through six low-cost community clinics. Participating physicians and some area residency programs can also refer established patients to the Project Access office for enrollment. Patients may be enrolled for primary and specialty care. Enrolled patients are referred out to other participating providers based on medical need. Sixty-nine pharmacies fill prescriptions at 15% below Average Wholesale Price and do not charge filling fees. Additionally, a Prescription Assistance Coordinator in the Project Access office assists patients in applying for donated medications through pharmaceutical companies to extend the $525,000 contributed by the City and County for prescriptions. In July 2002, Project Access contracted with a local telephone triage program to provide a Call-A-Nurse service for enrolled patients. Nurses field calls from patients Mondays though Fridays from 5 pm – 11 pm, and on Saturdays from 8 am – 6 pm and provide patients with information and support regarding a wide variety of health care conditions. In 2001, Project Access initiated a Hospital Emergency Department Case Management program to assist frequent utilizers of the area’s emergency departments in accessing appropriate primary health care. Case management teams located at the hospitals link patients to primary care and offer interventions to help patients become more empowered to manage their medical conditions. Patients have access to health care information, resources and educational services. An SRS Eligibility Specialist reviews each patient for eligibility for Medicaid and other state medical programs as well. Currently, Project Access is completing work on a three-year hospital utilization study of inpatient, outpatient and ED data for all uncompensated care patients. The results of this community-wide study will be reported and used within the community to improve and redesign the health care delivery system to better serve the uninsured and to lower costs.
OUR RESULTS Since September 1, 1999, Project Access has enrolled 4,101 patients who have received $22 million in donated medical care and services ($6.8 million from physicians and $15.2 million from hospitals). The program has purchased $1.5 million in prescription medications with funds contributed by the Sedgwick County Commission and the Wichita City Council. Enrolled patients and participating providers report consistently high rates of satisfaction with the program. And, early results of pre and post administered health and productivity assessments indicate that patients experience improved health status and become more productive at home and at work as a result of enrollment in Project Access. According to some nationally recognized statistics, the average cost of uncoordinated care is calculated to be $6,000-$6,500 per person annually. The program compared this formula against the value of the donated care provided to patients enrolled in Project Access for the first three years of service. Consequentially, the estimated cost savings achieved for providing non-fragmented care through Project Access participant is approximately $10 million dollars. According to the most recent report of results of the Hospital Emergency Department Case Management Program, there has been an 82.4% reduction in ED utilization by those patients receiving this intervention. These results correspond to an estimated cost avoidance for the hospitals of over $1 million, since the program’s inception. Most importantly, these ED patients are showing significant improvement in their health status, productivity and their personal sense of empowerment over their own health conditions, as measured by pre and post administered surveys.
WHERE WE ARE GOING Currently, Project Access is leading an initiative to link the six community clinics via a computerized patient enrollment and tracking system (a master patient index) to better coordinate services. Project Access is also poised to implement a volunteer emergency dental initiative led by the Wichita District Dental Society that will be operational by fall 2003. This community’s success in implementing the original Project Access model has led Wichita/Sedgwick County, Kansas to initiate additional activities and services to provide fuller access to health care services for more uninsured people at less cost to the community. For more information and further detail regarding Project Access please visit our website at: http://www.projectaccess.net.
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