Did You Know Project Access is PCC’s longest-running program? Implemented over 30 years ago, the program was the first of many demonstrating the Primary Care Coalition’s approach: building community partnerships to provide care and improve health. Project Access has operated for nearly three decades, and the FY24 Network Adequacy Study revealed opportunities for improvement. Specifically, it needed fresh eyes around communication, contracts and documentation, and barriers to recruiting additional specialty care providers. Those findings ignited the Specialty Care Improvement Project, led by PCC’s Director of Specialty Care Programs, Tefo Linchwe, and Lead Service Designer, Wenjing Zhang
Over the past year, Linchwe and Zhang connected with both internal teams and external partners to craft priorities that covered the full range of programmatic demands. This research included reviewing similar programs nationwide, along with conducting interviews, focus groups, and surveys among the programs’ diverse participants to understand the full program process. “We needed to understand real workflows, not assume workflows,” Linchwe says.
Participants included: PCC team members, primary care providers and referral coordinators, and specialty care practices staff and providers, and patients. (Research partners at the Rivera Group conducted patient interviews in multiple languages.) ,“It’s a joint effort,” explains Zhang. “Part of the service is PCC- but there's also specialty care offices, billing, and patients going on their own journey to get specialty care. Each person offers a few pieces that are needed to get a bigger picture.”
How does Project Access operate?
Project Access brings together an extensive group of providers (health care specialists, hospitals, and diagnostic facilities) to deliver the specialty care needed for low-income and uninsured Montgomery County residents. While the connection premise is simple, the operational reality is complicated. It is also a crucial part of the comprehensive care the Montgomery Cares system provides.
Montgomery Cares patients who need specialty care—physical therapy, for instance, or cancer treatment—receive referrals from Montgomery Cares health centers to the Project Access team at PCC. The team completes clinical and eligibility reviews of those referrals—returning some to the health centers if there is information missing—and works to connect patients with participating Project Access providers. Some patients are referred directly to our partners at Catholic Charities, a parallel network that provides care coordination and service connection for a reduced fee--bridging critical gaps in our network coverage and easing the coordination volume for our small Project Access team. The system not only has to connect patients with specialists who provide care but also to prepare patients for the visit—educating them about any pre-visit lab or imaging work needed, co-pays required, and translation support needed—and to ensure the results of the visit make it back to the patient’s primary health center for long-term care management.
“What makes Project Access work- it's not just about the processes and the contracts- it's about the people,” says Linchwe. The research process strengthened relationships and encouraged open communication, laying the foundation to begin making process changes. In fact, the data is already showing progress. Wait times have decreased even as referral volumes have increased, though Zhang notes that it’s impossible to tease out exactly which changes contributed the most.
With research concluding by the end of February and a new case management system on the horizon, the team is poised to bring meaningful and lasting improvements to Project Access. “Our goal with this process is to support staff and providers in doing what they do best: caring for patients,” adds Linchwe. And with that focus, the future of Project Access looks brighter than ever.
Over the past year, Linchwe and Zhang connected with both internal teams and external partners to craft priorities that covered the full range of programmatic demands. This research included reviewing similar programs nationwide, along with conducting interviews, focus groups, and surveys among the programs’ diverse participants to understand the full program process. “We needed to understand real workflows, not assume workflows,” Linchwe says.
Participants included: PCC team members, primary care providers and referral coordinators, and specialty care practices staff and providers, and patients. (Research partners at the Rivera Group conducted patient interviews in multiple languages.) ,“It’s a joint effort,” explains Zhang. “Part of the service is PCC- but there's also specialty care offices, billing, and patients going on their own journey to get specialty care. Each person offers a few pieces that are needed to get a bigger picture.”
How does Project Access operate?
Project Access brings together an extensive group of providers (health care specialists, hospitals, and diagnostic facilities) to deliver the specialty care needed for low-income and uninsured Montgomery County residents. While the connection premise is simple, the operational reality is complicated. It is also a crucial part of the comprehensive care the Montgomery Cares system provides.
Montgomery Cares patients who need specialty care—physical therapy, for instance, or cancer treatment—receive referrals from Montgomery Cares health centers to the Project Access team at PCC. The team completes clinical and eligibility reviews of those referrals—returning some to the health centers if there is information missing—and works to connect patients with participating Project Access providers. Some patients are referred directly to our partners at Catholic Charities, a parallel network that provides care coordination and service connection for a reduced fee--bridging critical gaps in our network coverage and easing the coordination volume for our small Project Access team. The system not only has to connect patients with specialists who provide care but also to prepare patients for the visit—educating them about any pre-visit lab or imaging work needed, co-pays required, and translation support needed—and to ensure the results of the visit make it back to the patient’s primary health center for long-term care management.
“What makes Project Access work- it's not just about the processes and the contracts- it's about the people,” says Linchwe. The research process strengthened relationships and encouraged open communication, laying the foundation to begin making process changes. In fact, the data is already showing progress. Wait times have decreased even as referral volumes have increased, though Zhang notes that it’s impossible to tease out exactly which changes contributed the most.
With research concluding by the end of February and a new case management system on the horizon, the team is poised to bring meaningful and lasting improvements to Project Access. “Our goal with this process is to support staff and providers in doing what they do best: caring for patients,” adds Linchwe. And with that focus, the future of Project Access looks brighter than ever.
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