Page 14 - 2023-September-October-Journal

To Everything a Season...
the Life and Legacy of Project Access Austin
By Marshall Cothran
roject Access Austin is
winding down its 22nd and
Pfinal year of service, which
recalls a line from a 1964 Chad
& Jeremy song, “They say that all
good things must end someday,
autumn leaves must fall.” Indeed.
Everything has a life cycle.
Project Access Austin (PAA)
was conceived in 2001 by then
TCMS president Dr. Tom McHorse. were asked to receive up to 20
Modeled after prototype programs PAA patients per year. Physicians
in Asheville, NC and Wichita,
KS, Project Access was a medical
society-led system of pro-bono
comprehensive health care for
uninsured individuals who, for
lack of eligibility for government
assistance programs, fell through
the holes in the health care
safety net.
Under the auspices of the
TCMS Foundation, TCMS
recruited a network of primary
care physicians, specialists,
hospitals, and diagnostic and
ancillary care providers who
agreed to donate their services to
patients with a Project Access
card. Enrolled patients had to
verify incomes at or below
150% of federal poverty
guidelines and that they had no
access to health insurance benefits
or government assistance.
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Project Access was born in
a private practice fee-for-service
health care environment in which
physicians could more easily
afford to set aside professional
time for pro bono work and were
happy to do so. PAA volunteers
in primary care were asked to take physicians would often say, “I’d
care of 10 PAA patients per year
in their offices, and specialists
who could not see PAA patients
in their offices could get Project
Access credit by volunteering in
one of our community’s free care
clinics. For pharmacy and certain
diagnostic services, Project Access PAA card would be honored
negotiated discounted rates and
paid the providers directly so that
care was still delivered at no cost
to the patient.
Many physicians were already
seeing patients who could not
afford to pay, but care was
episodic and fragmented due to
lack of access to comprehensive
care, leaving physicians feeling
frustrated that their efforts were
futile. However, by volunteering
through Project Access, physicians million again in 2009. Then the
could continue seeing these
patients knowing that the care they the bottom dropped out with the
provided would be complemented
by their patients’ access to
other components of the
care continuum.
Project Access
made doing good easy
and rewarding for
doctors and other
providers. They
would simply submit
a CMS Form 1500
2023 September • October
2023 September • October
with billed charges for each
patient encounter, not for
reimbursement but to document
and get PAA credit for the value
of free care provided. Given the
bureaucratic hassles and below-
cost reimbursement of Medicaid,
rather see a Project Access patient
for free than a Medicaid patient
for $10.”
Project Access also made
getting appropriate care an easy
and dignified process for the
patient. They would see a doctor
in their private office just
like paying patients, and their
just like the insurance card of a
private patient.
Since its inception, Project
Access Austin volunteer physicians
and providers have donated more
than $36 million in free care, or
roughly $1.7 million of free care
per year on average.
However, averages don’t tell
the whole story. In 2008, over
$3.4 million in donated care
was rendered and more than $3
curve reverted to the mean until
pandemic in 2020.
This period coincided with the
passage of the Affordable Care
Act (ACA) which at first was
thought to render Project
TCMS
TCMS