Katrina Gonzales, MD; Greg Stadter, MPH; Theresa Umhoefer Wittry, MD; Ann Christiansen, MPH
WMJ. 2026;125(2):276-279. Published June 2, 2026.
ABSTRACT
Background: Safety net clinics provide primary care to uninsured patients. However, receiving specialty care is more complex because most specialists are not employed by these clinics.
Methods: To improve specialty access, the Milwaukee Health Care Partnership created the Specialty Access for the Uninsured Program (SAUP). The program provides timely specialty care distributed equally across the 3 adult health systems in Milwaukee. This paper outlines the process and framework used to implement SAUP.
Results: Since SAUP implementation, 23 000 patients have been referred for specialty care, with a 91% appointment show rate.
Discussion: The current specialty access system is unsustainable. SAUP provides a framework to address inequalities in specialty care access.
Conclusions: The SAUP model demonstrates that a coordinated, equitable distribution of specialty referrals across health systems can improve access for uninsured populations. This collaborative framework offers a sustainable solution for other communities facing rising rates of uninsurance and the high costs of deferred care.