Opening Access to Health Care in Eastern N.C.

“We believe very strongly that everyone should have the opportunity to be healthy and have access to care,” says Janet Jarrett, executive director of HealthNet Albemarle. Her words describe the core of HealthNet Albemarle’s mission, vision and commitment to residents in Elizabeth City, N.C., and the six surrounding counties and communities around this historic eastern N.C. town.

With support from The Duke Endowment, the AccessHealth Initiative launched in 2008 to reduce health disparities, improve clinical outcomes, decrease avoidable hospital use and expand access to care among low-income, uninsured adults. Today, HealthNet Albemarle is one of 30 AccessHealth networks across the Carolinas, with 18 in North Carolina and 12 in South Carolina. Together, these networks provide access to health care to over 82,000 low-income and uninsured people.

Within each network, patients are first assessed by local health care professionals, often volunteers donating their time and expertise, and then assigned to a primary care provider. Patients are also supported with comprehensive care navigation to connect them with health resources from across the local network. Referrals for services, programs, treatment and preventative care in the network are based on the individual needs of each patient and are provided at greatly reduced or no cost.

Without this support, uninsured and low-income residents in many communities often delay seeking routine care, or treatment for chronic conditions. When symptoms reach a crisis, these patients then seek health care and treatment in local emergency rooms. “In our community, it was a real concern of how many people were accessing the emergency department when really it wasn’t an emergency. But because they were uninsured, they had nowhere else to go,” says Jarrett. 

Evaluation data show that in these AccessHealth network communities, both avoidable hospital stays and emergency room visits have declined by over 35 percent as patients receive regular care and connections to resources for well-being. Across the Carolinas, AccessHealth networks have provided medical care valued at over $637 million, and have avoided an estimated $150 million in hospital costs as emergency room visits have declined. (source: AccessHealthNC, 2023 https://www.ncha.org/programs/accesshealthnc/).

In each AccessHealth network, data is gathered to assess the program’s reach into uninsured and low-income populations, the effectiveness of tactics deployed, and to measure impact. Through a state-level portal, this data is shared to support continuous learning, collaboration and data-informed refinements to the program.

Alongside quantitative data, another critical source of information is fundamental to the success of HealthNet Albemarle and other AccessHealth networks: the voices of community members, caregivers, patients and their families. At HealthNet Albemarle, quality health care begins with listening.

“We ask them a lot of questions, to really get to know them,” says Jarrett. “We find out if they have transportation challenges, a possibility of domestic violence at home, or a language barrier? Are they food insecure? Do they have access to fresh vegetables? We take the time to find out key needs from our patients and then we refer them to resources that are available in the community.”

In addition to health care treatment and care for existing conditions, prevention has become a major focus of the AccessHealth network. Within each network, clients, patients and their health care providers work together to build knowledge and relationships that can help avoid many common health issues that affect large community populations, including obesity, high blood pressure and diabetes.

“We are at the doorstep now that instead of fixing a problem, we don’t have the problem – let’s stop it before it’s there,” says Jarrett.

These preventative and well-being resources include nutrition programs, food pantries, mental health and counseling programs, housing, transportation, fitness and dietary guidance programs, prenatal services and other supports.

With continuing support for expansion and innovation from The Duke Endowment, Jarrett says the work of HealthNet Albemarle and its companion programs across the Carolinas will continue to focus on opening access to comprehensive well-being supports and health care to residents without health insurance. There is strong evidence that progress is being made. In 2023, one out of every four low-income, uninsured people in the 30 AccessHealth counties were enrolled in an AccessHealth network.

“Our patients are the backbone of our community. We need them. We need them healthy. We need them happy,” Jarrett said. “Even with the Affordable Care Act (ACA), not everyone has access to insurance. So, we refer to ourselves [HealthNet Albemarle] as the last rung of the safety ladder. We’re reaching those that aren’t covered by insurance, and we’re going to stay on our mission for a good while.”

Learn more about AccessHealth networks.