Innovative health plan for uninsured ready to reach rural areas

A nationally recognized effort to provide health services to uninsured residents of Washoe County is ready to roll its partnership of the private and public sectors into Carson City and rural Nevada.

Access to Healthcare Network serves roughly 3,500 residents of Washoe County most of them working poor or employees of small businesses through a network of 500 health providers that includes physicians, dentists, hospitals, pharmacies and others.

The deal is straightforward: Health professionals provide care at a reduced fee. Members of the healthcare network pay cash upfront for their services and know that if they miss medical appointments they'll be booted from the program.

Expansion of the program out of its Washoe County base into rural Nevada is a big step for Access to Healthcare Network, which has kept tight reins on its expansion despite growing needs during the recession.

Sherri Rice, the founder and chief executive officer of the nonprofit, says the healthcare network takes on no more than 200 new clients a month. At that pace, the program each year provides new service to about 3 percent of the estimated 75,000 Washoe County residents who don't have health coverage.

"Quality control is everything," says Rice.

No one signs up on-line with Access to Healthcare Network. Instead, they come to one of the program's offices at Renown Medical Center or Saint Mary's Regional Medical Center and spend an hour with a staff member who walks them through the details.

Individual members pay $40 a month to access the network.

About half the members have been referred by employers who are unable to provide health insurance but pick up half or more of the monthly membership fee in Access to Healthcare Network. A family of four with an annual income as high as $55,125 is eligible.

Whether they're referred by an employer or find their own way to Access to Healthcare Network, members are eager to find rational way to provide healthcare for themselves and their families.

"Our members don't access their care in the emergency room," Rice says.

Instead, they work with a case coordinator who is assigned to them (the program has the equivalent of eight fulltime employees), and the coordinator directs them to a participating physician or medical facility.

Because they're putting up their own money, members tend to be careful consumers of health services, Rice says.

How eager are participants? Since Access to Healthcare Network began accepting patients in 2007, it's booted only 10 for nonpayment. Only two have lost their memberships because they failed to show for medical appointments. About three members voluntarily leave each month.

"People don't go off," Rice says. "There isn't another option for them."

Membership fees cover about a third of the operating costs of the network. Grants and donations cover the rest. Private fundraising created an account to help members pay the costs of catastrophic health expense.

A federal grant is jump-starting the expansion of Access to Healthcare Network into Carson City and neighboring counties, which will be followed by growth along the Interstate 80 corridor into other parts of rural Nevada.

The need, Rice says, is strong about 44,000 people are without health coverage in Carson City and rural areas. But the network's staff faces the work of creating a network of participating healthcare professionals and hospitals across the far-flung region.

The effort, the first of its kind in the United States, is closely watched by federal officials as they struggle with health care issues.

Rice met a few weeks ago in Washington, D.C., with U.S. Health and Human Services Secretary Kathleen Sebelius, who wanted to learn more about a program that Rice defines as shared responsibility between the uninsured, the medical community, employers and the community.

"We ask something of everybody, but we try not to overburden anyone," she says.