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Cost SharingPatient cost-sharing is limited to pharmacy co-payments.AdministrationPlusCare is managed by the PCMS.Project Access xviii,xix,8Buncombe County, North CarolinaStart Date: 1995OverviewProject Access is a collaborative initiative administered by the Buncombe CountyMedical Society (BCMS), connecting existing public and philanthropic primary care centers withprivate practice physician volunteers. Providers volunteer specialty and chronic health careservices to patients below 200% of FPL. The flow of patients from primary to specialty careservices is additionally supported by pharmacists providing pharmaceuticals at cost, hospitalsproviding free inpatient and outpatient services, and allocation of county indigent care funds toprovide medications for patients and ongoing operating support to sustain the initiative.Project Access began with the support of a Robert Wood Johnson Foundation planninggrant provided from 1994 to 1998. Community partners in Project Access include BCMS,Buncombe County Health Department, local volunteer clinics, area hospitals, the area healtheducation center, local pharmacists and the county human/social services. Physicians donatetheir services to Project Access by pledging to see 10 enrolled patients per year (20 patients ifthey are medical specialists). Most physicians (80%) in private practice in the area havecommitted to the program. Physicians see Project Access patients at their practices orvolunteer at a clinic. Physicians can limit their participation and/or withdraw at any time. Areahospitals provide all needed ancillary services free of charge, and the county contributes to thecost of prescribed drugs.Project Access operates in six safety net clinics in the community including the county’shealth department clinic, a federally qualified health center and an urgent care center. Eligibilityservices are provided at all sites and enrollees are centrally managed at BCMS’ office. BCMSis "headquarters" for the program and does provider recruitment, promotion and communication.Since Project Access’ inception, primary care sites have been able to serve more primary carepatients without increasing costs because patient care has been coordinated and continuous.For example since patients are able to readily access needed specialty care, appointmentspreviously consumed seeing patients repeatedly for unresolved specialty care needs are nowavailable for new patients and for proper management of existing patients' chronic primary careconditions.8 Personal Communications with Alan McKenzie and Kristen Neel, Buncombe County Medical Society, May 2005D-12