The Purpose

The Gateway to Better Health Demonstration Project preserves access to primary and specialty healthcare services for approximately 22,000 low-income, uninsured individuals in St. Louis City and County.

Approved on July 28, 2010, by the Centers for Medicare and Medicaid Services (CMS), Gateway to Better Health provides up to $30 million annually in funding for primary and specialty care as well as other outpatient services. The program was designed to provide uninsured patients a bridge in care until they were able to enroll in health insurance coverage options available through the Affordable Care Act.

Gateway to Better Health Extended through 2015

The State of Missouri has received an extension of its successful “Gateway to Better Health” (Gateway) Pilot Program from the Centers for Medicare and Medicaid Services (CMS). Gateway provides primary, specialty and urgent care coverage to uninsured adults in St. Louis City and County, aged 19-64, through a network of community providers and is sponsored by the Missouri Department of Social Services in partnership with the St. Louis Regional Health Commission. The extension of the Pilot Program will preserve up to $30 million in annual funding for community healthcare in St. Louis’ urban core. These funds will assist in providing a bridge for safety net providers and uninsured patients to coverage until long-term options are developed for Missouri.

Under the terms of the extension, Gateway will continue to cover individuals up to 100% of the federal poverty level (FPL) for primary, specialty and urgent care through December 31, 2015. For more information about Gateway eligibility, please visit

The RHC will continue to coordinate, monitor and report on the Demonstration Project. Since the Pilot Program began in July 2012, Gateway has annually paid for approximately 51,000 primary care visits, 29,000 specialty care visits, and 230,000 medications for the uninsured in St. Louis. Gateway also prevents an estimated 50,000 to 70,000 unnecessary emergency department visits each year.

Through 2015, the funds provided by the Demonstration Project will be used to provide outpatient coverage for eligible individuals in St. Louis City and County. With the approval of the Demonstration Project extension, the Commission will continue working with its partners to ensure Gateway members maintain access to quality primary and specialty care services in the St. Louis region.

For more information, please contact Angela Fleming Brown at (314) 446-6454.

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