 |
Katherine Morris , MD
NW Surgical Oncology
Project Access
Volunteer Physician |
Project Access NOW:
Overcoming barriers to care
by Jerry Rhodes, Communications
CareOregon is part of collaborative to help the uninsured.
One Oregonian per day dies due to lack of health insurance, according to a report by Families USA.
Now CareOregon has joined a collaborative of health care volunteers trying to change that grim statistic for the Portland-Vancouver Metropolitan Area.
Project Access of Northwest Oregon and Washington (PANOW) is a collaborative effort to give infrastructure to donated health care and to coordinate access to specialists and other health services for low-income uninsured patients. Project Access rolled out in Clark and Multnomah counties March 3 and Washington County April 1. Clackamas County planning is in the early stages.
"What Project Access does is make it easier to donate care to the most vulnerable by coordinating a volunteer network and arranging for free testing, medications and procedures," PANOW executive director.
 |
Rachel Solotaroff, MD
Old Town Clinic
Project Access
Volunteer |
CareOregon is a partner
CareOregon will provide patient identification cards and handle claims paperwork at no cost for Project Access in Clackamas, Multnomah and Washington counties. Columbia United Providers will provide the same services in Clark County.
“That’s huge,” Nilsen-Solares says. “It’s another piece of what makes Project Access work so well.
"We will know how many patients were served and by whom. We will know how many appointments a patient made to a specific volunteer. We will be able to report the value of charges that were written off by volunteers. And we’ll be able to assure equity between hospital systems and even subspecialty volunteers."
Claims Examiner Supervisor Jeremy Brown says that Project Access is expected to have only about 40 clients within six months.
"In terms of our staff, it’s really going to have a minimum impact," he says. "We average one claim per member per month so we expect an additional 40 claims. We’re already handling 100,000 claims, so 40 more is just about unnoticeable."
One reason for that is the work Information Systems is doing up front. IS is creating an entirely separate environment.
"We’re going to process the Project Access claims separately from our regular claims," Jeremy says.
He notes that CareOregon’s vision and mission of assuring that Oregonians have access to high quality health care, regardless of income or social circumstances
"That’s pretty much what Project Access is trying to do," he says.
The safety net’s safety net
Dr. Katherine Morris a volunteer for Project Access Multnomah County, explains the need.
Dr. Morris is a surgical oncologist in practice at Legacy Good Samaritan Hospital and Medical Center. Like many health care providers, she often provides free health care for those in need.
But when a patient needs more than the safety net can provide, then both patient and doctor face formidable obstacles.
Even when there is a specialist like Dr. Morris who is willing to provide care, too often the doctor or safety net clinic has to track down and identify labs, diagnostic imaging providers and hospitals willing to give services free.
Cancer surgery, for example, can involve radiology, anesthesiology, nursing, hospital inpatient services, pathology and support staff such as respiratory and occupational therapy. It requires a great deal of coordination can be very complex, Dr. Morris says.
"I can do the charity case, but all the other parts have to be arranged by the hospital,” she says. “If I can’t get that support, I can’t do what I need to do."
Coordinating these services can delay surgery by a couple of weeks and it can use valuable time and resources that the doctor or clinic could have spent on diagnosis and treatment.
Project Access’ role is to recruit volunteers and provide coordination
As soon as a problem is identified that needs services beyond those of the safety net clinic, the patient is referred to Project Access. Project Access care coordinators facilitate treatment through a network of volunteer specialists, hospitals and other health care service providers.
"We see Project Access NOW as the ‘safety net’s safety net,’" Nilsen‑Solares says. "We want potentially serious medical problems to be resolved rather than having patients return again and again to have the symptoms treated by the safety net clinic, or having them wait until there is a crisis."
Poor access costs us all
The biggest frustration for physicians—and danger for patients—are the times when a patient may not yet have a life-threatening problem, but can’t afford to get needed treatment, Dr. Morris says.
She recalls a woman who had a lump in her breast and needed surgery. Without health insurance or access to inexpensive care, she had delayed making an appointment with Dr. Morris for several months.
By that time, the disease was in an advanced stage and had spread to the woman’s internal organs.
"If she had primary care, if she had access to specialty care, it’s highly likely that this would have been caught earlier and she would have had a chance," Dr. Morris says.
But she didn’t have a chance. She died, not yet 35.
Access depends on collaboration
Project Access "is not the complete solution for heath care," Nilsen‑Solares says. "It’s an interim step. We’re coordinating needed services while creating little additional infrastructure and no duplication.
"We’re also building the relationships that we’ll need for any significant health care reform in our community."
Project Access NOW and the United Way of the Columbia-Willamette have a strategic partnership to make effective use of resources, promote volunteerism and ensure clear, measurable outcomes that make a difference in our communities.
All the health systems and larger insurers in the metropolitan area have joined the effort.
"Certainly in the history of our area, there is nothing that has had all the health systems working together to support the safety net," Nilsen‑Solares says. "We’re very proud of that."
Who is eligible?
A patient will be prequalified as eligible if he or she lives in the county and has: income no greater than 200 percent of the Federal Poverty Level, no access to insurance and a demonstrated medical need.
Without Project Access prequalification, patients needing charity care would have to provide proof of income for each different provider. Without Project Access, all the separate components that make up a complicated procedure such as cancer surgery would be cobbled together through a great deal of hospital, physician and patient effort.
With Project Access, it becomes as simple for patients as enrolling in the program, receiving ID cards and showing up to their appointments.
top of page |
