Do you have workers who don’t qualify for your company health plan, but for whom you’d like to provide affordable health care? Do you find insurance premiums too high to offer health coverage at all? Or do you offer it, but find too many workers can’t afford the copays?

HealthAccessRI, a program launched a year ago to make primary care accessible to people who are uninsured, is now reaching out to employers, betting that, especially in a recession, many could use the program’s help to keep their workers healthy.

The program already has its first employer contract, with Nursing Placement Inc., of Pawtucket, which also provides discounted-rate services to Access members. But through the end of the year, it’s waiving sign up fees of $15 to $80 per person to entice more employers.

“We see Access as either a stopgap or a step up to insurance for people,” said Dr. Michael Fine, of Hillside Family and Community Medicine, who developed the concept with other physicians.

“It’s a great thing for employers to use for their employees who are part-time and don’t qualify for insurance, or who are trying to figure out how valuable insurance is to them,” he added. “And it’s a great stopgap for employers who can’t deal with increases in health insurance costs ... and in that case, HealthAccess is much better than nothing.”

Low-income and uninsured workers in Rhode Island do have other options already: Parents and children may qualify for RIte Care, the state’s Medicaid program, though especially for nonpregnant adults, the income cutoff is low, 185 percent of the federal poverty line.

There are also community health centers, which offer comprehensive primary care to all comers, with a sliding fee scale for the uninsured.

And local hospitals, of course, serve everyone as well and also offer sliding fees, but the costs, especially if you seek care in the emergency room, can rack up quickly.

HealthAccessRI offers an appealing alternative: Your own primary care doctor, just as you’d have if you were insured, except with a very different payment structure.

Depending on the practice, there’s an enrollment fee of $15 to $80 per person, plus a monthly fee of $25 to $30. The bottom line: For $315 to $440 a year, plus $5 to $15 per visit, you can have a doctor who’ll cover all or most of your medical needs.

Of course that price doesn’t cover services that the participating doctors can’t provide – whether it’s a consultation with an endocrinologist or cardiologist, an ER visit, or the lab analysis on a Pap smear – and it doesn’t cover prescription costs.

But the program does have deals with East Side Laboratories, three imaging providers, a podiatrist, the Rhode Island Rehabilitation Center, and Nursing Placement Inc., a home care provider, that allow Access members to pay the same as Medicare, the lowest allowable charge and substantially less than the typical out-of-pocket rate.

Combine that with a drug discount card like the Health Savings Pass that CVS/pharmacy just unveiled – pay $10 a year and you can get 90-day supplies of any of 400 commonly used generic drugs for $10 each – and the financial challenges of being uninsured are greatly reduced.

“The patients love it,” said Dr. James Schwartz, of Family Doctors of East Providence, one of 26 doctors in nine practices that accept Access patients. “My impression is that they feel comfortable knowing that they have a medical home and a regular doctor the same way that they would with medical insurance, and that takes them quite far in feeling secure.”

Yet despite media coverage, outreach to three chambers of commerce and the Rhode Island Hospitality & Tourism Association, and even some cold-calling by Kimberly A. McHale, executive director of the Rhode Island Academy of Family Physicians, which runs the program, only about 600 people have signed up so far, McHale said.

“It feels like it’s a well-kept secret, and the reason is that we don’t have a huge budget to advertise,” she said. “To make something really fly, it takes some time for people to hear about it over and over again, and we can’t afford to do that.”

The pace of sign ups has been accelerating: In October, 40 people joined, up from about 30 per month before earlier in the year, McHale said.

Doctors are also pleased, and as many as three new practices may be joining, McHale said. Schwartz said his own practice has about 60 Access patients, “which is less than we would hope to have,” and the system works financially.

For employers, the way McHale has structured the program is that a company signs a contract and then provides vouchers for its workers, agreeing to pay the enrollment and monthly fees. Through the end of the year, as a special promotion, Access is waiving the fees to sign up, so an employer can join by just agreeing to pay $75 or $90 for three months of service for each worker who participates. •