Frequently Asked Questions: Project Access
What is Project Access?
Project Access is a system that provides healthcare to low-income individuals who do not have insurance, nor do they qualify for public assistance. Project Access patients see physicians for free (both primary care doctors and specialists) and get all other healthcare services they need at no cost (hospital inpatient and outpatient services, lab work, x-rays, rehabilitation, medications, etc.).
How does Project Access work?
Simply put, Project Access is based on physicians volunteering their time to see patients for free, and other community partners, such as hospitals, donating the other medical services the patients need.
Do doctors already sometimes provide free care?
Most all physicians have treated patients who were not able to pay, either in their offices, in community clinics or in the emergency room. Hospitals also provide charity care. This care is often fragmented and the patients served usually lack full access to medications, diagnostic services and physician specialists.
In a Project Access system, this already existing (but fragmented) charity healthcare is organized into an equitable, cost-effective system. By donating care as part of an organized, integrated system, the care physicians and hospitals give in a Project Access system results in better health outcomes for patients and lower overall, long-term costs to the providers and the community.
Who is eligible for Project Access?
Typically, those who are eligible are age 18 to 64, have no medical insurance of any type, do not qualify for Medicaid or Medicare, and have gross household income of less than 150% of the federal poverty level (income criteria varies across communities). If a patient is eligible for Medicaid or Medicare he/she is required to accept it.
How does Project Access differ from Medicaid or Medicare?
Medicaid and Medicare are federally funded programs. Medicare is for people 65 or older. Part A provides free inpatient hospitalization, skilled nursing care, and hospice care. Part B of Medicare is optional and helps cover physicians services and outpatient hospital care. It costs about $60 per month.
Medicaid is a program that covers low-income pregnant women, infants and the disabled. Sixty percent of the money is federally funded; 35% comes from the state and 5% is county-funded. The financial eligibility is 185% of federal poverty level for pregnant women and infants under 1 year of age. Contrary to popular belief, the majority of low-income individuals are not eligible for Medicaid.
Project Access is a community-based healthcare system that is financed and supported locally through the donated care of local providers.
Who qualifies for Project Access?
Each Project Access community may have different standards for accepting Project Access patients. In Buncombe County (Asheville, NC), where the system originated, the criteria are as follows:
- Patient must live in Buncombe County
- Patient cannot have any type of health insurance
- Patient must have household gross income of 200% or less of the federal poverty level
How do patients become enrolled in Project Access?
Patient must be referred to Buncombe County Medical Society Project Access by the health department, one of our community clinics, or private physicians.
Is there a limit as to how long a patient can be enrolled in Project Access?
No. The average enrollment in BCMS Project Access is approximately 6 months. Patients are rescreened for eligibility on a 3 or 6 month basis. More than 50% of patients become insured after 12 months.
Is there a limit to the number and kind of services a patient can receive through Project Access?
Typically, physician and hospital services are not limited. There is a list of medications (a formulary) that the patients have access to using their Rx card and there may be an annual cap on medication expenses per patient. Only healthcare services and medications received in the patient's own Project Access community are covered.
How was Project Access developed?
The Project Access system was developed in 1995 by physicians in the Buncombe County Medical Society in Asheville, NC. It has since won numerous awards and recognition, including an Innovations in American Government award. Communities all across the country are now replicating this model of care.
How do I know if Project Access can work in my community?
To find out how whether Project Access can work in your community, or to learn how to get such a system started, contact Physicians' Innovation Network.