Expanding the Safety-Net of Specialty Care for the Uninsured

A Case Study

In New Haven, Conn., a two-year process was followed to implement a Project Access model of care to increase capacity of the safety-net system to accommodate the specialty care needs of the uninsured. At the core of its patient-focused care plan, Project Access patient navigators help patients schedule medical appointments and tests, get access to free or discounted prescription medications, negotiate language and literacy barriers, and connect with health-related resources.

The project team applied the principles of community-based participatory research to engage stakeholders in implementing Project Access. Specifically, they:

  • assessed the scope of the problem of access to specialty care for the uninsured
  • engaged key stakeholders including community members, health care leaders and potential funders
  • defined the goals of the project
  • established the evaluation and research agenda
  • disseminated and translated research findings

Among the important lessons learned: By expanding the infrastructure of physicians and providers caring for the uninsured, no one physician or hospital was overwhelmed. In the service population of Project Access–New Haven, where two-thirds of the patients are Latino, the patient navigators proved invaluable in building trust in the medical system, addressing language barriers and improving adherence to a care plan.