NHSC Experience Gives Rise to a Small Miracle

Today, Buncombe County, North Carolina, is one of the few places in America where there is near universal access to quality health care. This is the result of the Buncombe County Medical Society's (BCMS) Project Access, an ambitious experiment begun in 1994 to coordinate all aspects of health care under one grand scheme.

Suzanne Landis, M.D., a former National Health Service Corps (NHSC) Scholar, and Alan McKenzie, executive director and CEO of BCMS, were the architects of what is considered the Project Access miracle. And their award-winning model is being studied and emulated across the country.

Landis and BCMS spun the miracle into an interdependent tapestry by meeting with every group involved and negotiating roles, goals, and responsibilities. In town hall-style meetings and through personal interviews, problems, misgivings, and reservations were identified and solved one at a time until a complete pattern of services and procedures emerged.

Project Access is a win-win model of complete health coverage. It formalizes generalist and specialist clinician and supportive agency commitments to unpaid and subsidized health services in the community. The State and county budgets for public health are folded into the mix to pay for basic elements such as prescription drugs and laboratory and hospital fees.

Just as the challenge of providing access is spread evenly among the participants, the project's success has also been spread equally among its stakeholders. More than 13,000 of a possible 15,000 patients living at or below 200 percent of the Federal poverty guidelines are enrolled recipients of Project Access services.

Participating clinicians donate $3.5 million in services a year. As a result, they have actually decreased their non-paying patient load in the process.

Participating hospitals have reduced emergency room usage for non-acute, non-emergency and preventable cases by 9 percent. As a result, the cost of uncompensated care dropped by $120,000 in the first year of the plan. The county realized a reduction in health care spending from $600,000 per year to $350,000.

Project Access is proof that providing quality health care access to all, regardless of their ability to pay, is a reasonable and achievable goal. It is also proof positive that the most workable and creative ideas for dealing with health disparities are born of the NHSC experience.

Learn about other NHSC success stories.