Created in 1996 by medical society physicians, Project Access is a comprehensive, volunteer network of over 650 primary care and specialty physicians in Buncombe County. They serve at no charge over 4,000 low-income, uninsured people annually at a value of over $14 million per year. It is a dynamic partnership of physicians, community clinics, the local hospital, radiology service providers, lab service providers, medical suppliers, medication assistance programs, and local pharmacies. Project Access physicians receive no payment for their donations. The improved health and gratitude of their patients is the compensation they receive.

The study was directed by Mark Hall, Professor of Law and Public Health at Wake Forest University Medical School, which looked at many community health programs for the uninsured, with a goal of identifying the best of such systems.

Prof. Hall and his research team at Wake Forest University obtained a grant from the Robert Wood Johnson Foundation to study the best of the systems in the country for the care of the uninsured, in terms of costs and adequacy of the safety net for the uninsured.

Miriam Schwarz, Executive Director of WCMS, points to a key finding of the study: Uninsured patients seen at the County's clinic and in the Project Access program had emergency room visits at less than half the level of Medicaid patients in Buncombe County or statewide in North Carolina. This indicates good access to primary care, which is confirmed by the finding that these patients utilized primary care in similar numbers to those on Medicaid, and their use of specialist care was similar to the national rate for people generally.

In August 2011, the WCMS Foundation Board of Directors, which runs Project Access, made plans to overhaul the program. And effective Sept. 16, participants must be below 133 percent of federal poverty benchmarks rather than the prior requirement of 200 percent. Participants also must now have lived in Buncombe County for one year compared with the previous requirement of six months.

"Somehow, physicians continue to give stratospheric amounts of free care," Schwarz says. "They're participating at higher and higher levels, even though their costs are going up. It's sort of miraculous. Last year, around $14 million worth of care was donated to Project Access patients; this year, we're on pace to be much higher than that."

The complete report of this study was published in late June 2010 on the Robert Wood Johnson Foundation site at http://www.rwjf.org/pr/. The title of the study is 'The Costs of Adequacy of Safety Net Access for the Uninsured.'

Miriam Schwarz, MPA has served as the Chief Executive Officer of the Western Carolina Medical Society Association - the 875+ member voluntary professional association of physicians in the 16 western counties of our region - since June, 2007. Ms. Schwarz directs the Medical Society's advocacy and educational activities of the Association for the well-being of patients, for the health of our community, and for the profession of medicine. In addition to managing the Association, Ms. Schwarz serves as the Executive Director of the Society's charitable foundation. Ms. Schwarz has resided in Asheville with her husband, Ed Katz, and four children (Jacob, Josh, Hannah, and Eli) since 1992.

(Images provided by Jewish Community Center of Asheville.)