Contrary to popular perception, community programs created to improve healthcare access or provide insurance coverage don’t attract chronically ill enrollees who need costly medical services, found a study of three community programs funded by the Robert Wood Johnson Foundation’s Communities in Charge initiative. Enrollees in two of the three community programs examined by the study, published in Health Affairs, were in good to excellent health with no chronic health problems. And at all three sites, the low-income uninsured adults primarily accessed physician services rather than those of a hospital or emergency room. After enrolling, participants received much more prevention services than they had in the past. Having the assurance they could access medical care, rather than dissatisfaction with previous care, was the reason most participants—half of whom were working—enrolled. Six months later, two-thirds of participants were still enrolled. Those who dropped out typically had found a job with health insurance, became eligible for a public program, or failed to fill out the paperwork to stay enrolled. Less than 5% left because they felt they no longer needed health care.
