The Health Wagon
- Need: Healthcare access for the medically underserved in Central Appalachia.
- Intervention: A mobile clinic that provides free healthcare in 11 rural Virginia communities.
- Results: The Health Wagon provides comprehensive healthcare services to over 4,000 patients annually.
Evidence-levelPromising (About evidence-level criteria)
The Health Wagon was started in 1980 by Sister Bernie Kenny to meet the healthcare needs of people living in Virginia's Appalachian mountains. It was supported for the first 25 years by St. Mary's Hospital, Norton, Virginia.
The Health Wagon's mobile clinic visits 11 rural communities in southwest Virginia's Buchanan, Dickenson, Lee, Russell, Scott, and Wise Counties to provide free healthcare to those in need. According to Health Wagon's 2016 report, 98% of patients served by the Health Wagon are uninsured and the average patient age is 38 years old. The organization's 2017 report indicates the nearly 4,200 patients received care in that calendar year and of those, 86% uninsured.
In addition to the mobile clinic efforts, care is provided at 2 stationary clinics in Wise and Dickenson County.
The program is staffed by 3 full-time nurse practitioners, 2 part-time nurse practitioners, 4 nurses, 1 operational director, 1 development director, 1 outreach coordinator, 1 administrative assistant, 2 receptionists, 1 part-time IT staff member, and 2 part-time office support staff. The Health Wagon also has 2 volunteers who come on a weekly basis.
Since 2000, the Health Wagon has also partnered with Remote Area Medical (RAM®) Volunteer Corps to provide annual coordinated care events in multiple areas within their combined service area, reaching thousands of patients.
Health Wagon has been involved with two "firsts": in 2016, the first telemedicine bladder cancer screening performed as a joint venture with the University of Virginia; and in 2015, the first FAA-approved drone medication delivery, as a joint venture with (RAM®), and four additional organizations.
Past funding efforts supporting the Health Wagon included a 2009-2012 Federal Office of Rural Health Policy Rural Health Care Services Outreach grant. Health Wagon's continues its work as a non-profit charity funded by multiple foundations and private donations.
Visiting 11 communities in southwest Virginia on a weekly, biweekly, or monthly basis, The Health Wagon offers rural residents a wide-range of healthcare services, including:
- Acute disease management
- Behavioral health clinics
- Cardiac specialty clinics
- Cardiovascular disease management
- Chronic disease management
- Colonoscopy clinics
- Diabetic education
- Diabetic retinopathy screenings
- Ear, nose, & throat clinics
- Endocrinology clinics
- Hearing aid assistance
- Influenza vaccinations
- Lab & diagnostic services
- Medication assistance
- Nephrology specialty clinics
- Ostomy clinics
- Physical assessments
- Pulmonary clinics
- Referrals and follow-up systems
- University of Virginia (UVA) telemedicine capabilities
- Women's health clinics
- Wound care clinics
In 2017, Health Wagon sponsored the Department of Defense's Innovative Readiness Training at the Wise County Fairgrounds. This activity provided additional no-care to individuals in southwest Virginia, Kentucky and Tennessee.
According to the Health Wagon's 2016 annual report:
- 6300 active patients
- Nearly 9000 patient encounters
- $6.1 million of healthcare value provided (including dollar value of care provided by RAM® activities)
- In 2014, establish the first ever telemedicine wound care clinic in partnership with UVA telemedicine
- In 2015, first ever FAA-approved drone delivery of medications to the Wise County fairgrounds
- In 2016, first telemedicine bladder cancer screening effort in conjunction with the University of Virginia
The Health Wagon was featured on 60 Minutes in April 2014. The TV segment provides an in-depth look into the services the Health Wagon provides and the healthcare needs it addresses:
- Affordable Care for Those Still Uninsured (60 Minutes)
- On the Road with the Health Wagon (60 Minutes Overtime)?
- How the Health Wagon Got Rolling (60 Minutes Extra)
- The People of Appalachia? (60 Minutes Extra)
More media features including:
- Gaping, painful holes remain in U.S. health care despite coverage gains (PBS Newshour)
The Rural Monitor:
For more information on the program's impact:
- 2017 Health Wagon Annual Report
- 2016 Health Wagon Annual Report
- Gardner, T., Gavaza, P., Meade, P., & Adkins, D.M. (2012). Delivering Free Healthcare to Rural Central Appalachia Population: The Case of the Health Wagon. Rural and Remote Health 12 (2035).
Accessing transportation to appointments as well as specialty services is an ongoing barrier for patients whom the Health Wagon was created to serve.
Mobile and episodic healthcare delivery
Pharmacy and prescription drugs
November 1, 2012
Date updated or reviewed
November 22, 2017
Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.