Context: Specialty Access for Uninsured Program (SAUP) is a county-wide collaborative in which safety net clinics (primary care) are paired with private health systems (provision of specialists). Specialty services are “covered” under SAUP at no cost.

Objective: Examine the clinical, geodemographic, and referral/utilization features of our SAUP patients.

Study Design: Prospective enrollment, retrospective review, descriptive statistics; regression models were used to explore predictors of time from referral to specialty visit.

Setting: Milwaukee County, WI, USA. Patients: ≥ 18 years old that were enrolled in SAUP during 2017. To be eligible for SAUP (i.e., managed care) patients must be established patients of our free clinic, at ≤ 200% Federal Poverty Level, and uninsured.

Results: Of the 99 patients enrolled in SAUP, mean age 46.5 years and BMI 30.9 kg/m2, 52.5% were female. Patients were predominately Hispanic (98.0%), Spanish speaking (93.9%), had contact with PCP prior to enrollment (84.4%), and resided in two ZIP codes within Milwaukee County (85.9%). At the time of SAUP enrollment, patients primarily had hypertension (21.2%) and diabetes (23.2%). Overall, SAUP patients were generally well, with 76.5% having a modified Charlson comorbidity index score of zero. Of the patients enrolled in SAUP, 90.9% followed through with the specialty visit to date. Top specialty services to which patients were referred included gynecology (13.1%), colonoscopy/colorectal surgery (12.1%), and ophthalmology (11.1%). The mean time between enrollment and specialty service visit was 30.1 days (median 24.5 days), and no predictive variables were identified. Following the specialty services visit, 42.2% had contact with a PCP to date.

Conclusion: Patients in a managed care specialty access program coordinated through our free clinic are relatively young and healthy, with follow through percentages and wait times for specialty care at or better than national averages of generally insured populations. Further research, including cost outcomes is warranted.