JCMS Project Access

Irby Ferguson, Project Access Program Director

New Initiative Provides Care to Low-Income Patients

Say that you have patients who don't have health insurance. They're not eligible for Cooper Green Mercy Health Services, the Veterans Administration, Medicaid/Medicare, or for a subsidy through the Affordable Care Act. They are one of the many patients who fall between the cracks when it comes to receiving medical care.

A recent initiative from the Jefferson County Medical Society, collaborating with several community partners, is named Project Access and is aimed at connecting those patients with primary, ancillary, pharmacy services, and specialty care from hospitals and physicians who volunteer for the program.

The Project Access concept originated in Buncombe County (Asheville) North Carolina more than 20 years ago and has been implemented in some 40 cities across the U.S. "We started talking with our community partners about implementing Project Access in Birmingham about 18 months ago" says program director Irby Ferguson. "Our effort is designed to help those patients obtain specialty care and ancillary care and to help them establish a medical home if they do not have one."

Process Access is intended to provide care primarily to patients from Jefferson County, but because Birmingham's metropolitan area stretches to Shelby, Blount, and several other counties, there are occasions where patients from adjacent counties can also qualify.

Besides helping low-income individuals, the services also provide a cost savings to hospitals. "The great thing about the program from a hospital's standpoint," Ferguson says, "is that patients who have unmet health needs no longer have to show up in the ER because they have nowhere else to go. Patients can be redirected to Project Access where they can locate and establish a medical home to receive ongoing primary care services. Primary care providers then make referrals for specialty and ancillary care as needs are presented."

"The program is beneficial to specialists as well," says Martha Wise, executive director of JCMS. "Specialists don't have to provide primary care for the patient. They need only provide care in their specialty. For example, an orthopedic surgeon might see a patient in the emergency room who suffered a broken leg that requires surgery. Patients who have no primary care home often ask the specialist about their other health problems."

This can put the physician in the awkward position of having to give advice or write prescriptions for conditions outside his specialty. By pairing patients with primary care homes, the specialist can focus treatment solely on the problem within his specialty.

Another benefit for volunteer specialists is that they can channel all charity care from their office through Project Access and limit donated charity care to match their business's budget. The physicians are asked for a one-year commitment to Project Access and they can specify how many patients they are willing to see during that one-year period.

The Community Foundation of Greater Birmingham provided the initial funding for Project Access through a grant program, and some area hospital systems have provided financial support. As a non-profit, Project Access is looking for broad-based community support from other hospitals, community groups, businesses and individuals.

"We're also looking for additional physicians and service providers and we'd love to get more people involved in the program," Ferguson says. "You don't have to be a member of the Medical Society. We just began the program in October and currently have about 50 volunteer providers from independent offices in local communities. UAB Health System is now fully onboard, so it includes many physician specialists from their system. St. Vincent's Hospital and onsite providers have been supportive of our program and provided financial support as well. St. Vincent's has also made free medications available through their Dispensary of Hope pharmacies.

"Project Access is a good program because it's a community problem being addressed by the whole community, and it's a wonderful way for the entire community, from primary care doctors, specialists, community clinics and hospital systems--even those who normally compete with one another--to become involved. They get together and reach an agreement on the best way to provide care for patients who are falling through. It ends up being a really beautiful blend of best health care practice, best business practice, and mission. So, it's a win-win for just about everybody."


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Affordable Care Act, Cooper Green Mercy Health Services, Dispensary of Hope, indigent patients, Irby Ferguson, Jefferson County Medical Society (Alabama), low-income patients, Martha Wise, Project Access, St. Vincent's Hospital, UAB Medical System, Veterans Administration




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