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CHEER (Clinica Esperanza/Hope Clinic ER Diversion Project) is a time-tested solution to providing uninsured patients with access to primary care. In Rhode Island, nurse-run ambulatory care clinics can operate under the supervision of a physician. At CHEER, nurses see uninsured walk-in patients, assisted by medical observers (international medical graduates), medical students and trained community healthcare workers (Navegantes). Medical care is provided using established protocols under the guidance of the MD Medical director, who maintains contact with the clinic by cell phone and reviews all of the patient interactions using the electronic medical record system. A five month pilot (see J Comm Health publication) demonstrated significant positive impact! We recently assessed the impact of CHEER in 2013: In terms of QALYs, we saved $7.8 million and successfully diverted 361 patients from the ER, reducing potential out-of-pocket costs by $274,360, for an estimated return on each dollar invested of $53.41. In addition, hundreds of patients are connected to primary healthcare in our continuity of care clinic. Now that's a great way to improve access to care!