# Alleviating Costs for Critical Eye Specialty Services (ACCESS): a prospective cohort analysis of a cost-coverage program at a public safety-net hospital

## TL;DR

A new hospital program in the US helps low-income patients access essential eye care services at no cost, reducing vision loss and disability.

## Contribution

The ACCESS program is a novel hospital-based cost-coverage initiative that addresses financial barriers to specialty eye care for underserved populations.

## Key findings

- ACCESS provides essential vision-restorative treatments at no cost to patients through hospital and philanthropic funding.
- Early outcomes show marked reductions in visual disability and downstream economic benefits compared to program costs.
- The program demonstrates how cost-coverage initiatives can reduce disparities in vision care and inform policy development.

## Abstract

In the United States, gaps in public insurance coverage and high out-of-pocket costs for specialty ophthalmic services contribute substantially to preventable vision loss and disability among underserved populations. We describe the structure, implementation, and early outcomes of ACCESS (Alleviating Costs for Critical Eye Specialty Services), a hospital-based cost-coverage program established at an urban safety-net hospital to address these financial barriers. ACCESS delivers essential vision-restorative treatments frequently excluded from insurance coverage at no cost through hospital support and philanthropic funding. Prospective clinical and demographic data demonstrated marked reductions in visual disability among treated patients and substantial downstream economic benefit relative to program costs. These findings demonstrate that targeted cost-coverage programs embedded within safety-net systems can reduce disparities in vision care, while providing actionable evidence to inform hospital policy development and support broader expansion of insurance coverage for high-impact ophthalmic specialty services.