GiveBetter x Houston

AccessHealth

Fort Bend and Waller integrated clinical access

Research time: ~2 min on GPT-6.1 Sol
  • Research — reviewed programs, finances and impact evidence.
  • Modeling — estimated costs, QALYs and uncertainty.
  • Source audit — checked claims, assumptions and calculations.

Updated: 2026-10-05

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Summary

What do they do? AccessHealth provides primary, dental, behavioral and other healthcare services to low-income families in Fort Bend and Waller counties. Its integrated clinics also offer pharmacy, nutrition, HIV and hepatitis care, with insurance acceptance and income-based fees. The organization connects patients with continuing treatment and assistance rather than relying only on episodic medical visits.

Why we’re interested in this organization:

  • Current primary services identify insurance, sliding fees and medication-access mechanisms.

  • Three original annual returns verify recipient identity and current recognized cost.

  • Original service counts distinguish encounters and nutrition recipients rather than claiming all contacts are unique treatment completions.

Our main reservations:

  • Repeated visits, household duplication and clinical treatment completion are not verified.

  • The modeled adult utility and actual net household resource effects are unsupported priors.

  • Whole-recipient cost includes additional services and geography beyond this narrow adult medical channel.

What do you get for your dollar? $12.6M per DALY in Houston. DALY is our one-year comparison unit. QALY-based health gains and income-welfare equivalents retain their original assumptions; they are not measured clinical DALYs. Conditional annual whole-recipient cost divided by a limited modeled local channel; not a verified marginal gift offer or complete portfolio EV.

Medical encounters mapped by explicit weak priors to unique adult household opportunities; additional appropriate treatment and finite symptom relief, not visits as QALYs.

1. What do they do?

AccessHealth provides primary, dental, behavioral and other healthcare services to low-income families in Fort Bend and Waller counties. Its integrated clinics also offer pharmacy, nutrition, HIV and hepatitis care, with insurance acceptance and income-based fees. The organization connects patients with continuing treatment and assistance rather than relying only on episodic medical visits.

2. Monitoring and information sharing

FY2025 original reports 51,493 medical encounters, 6,670 dental encounters, 8,146 behavioral encounters and additional nutrition/optometry contacts. These are not unique patients and are not added into one cohort. WIC recipients across five counties are not extra independent Houston clinical or cash beneficiaries. Request medical visit-to-unique-adult and household ratios, completed dose, clinical utility follow-up, actual household net payments and alternative-care use. Current Medicaid/Medicare/private insurance, sliding fees and 340B arrangements form the reimbursement counterfactual.

3. Qualitative assessment

Current primary services identify insurance, sliding fees and medication-access mechanisms. Three original annual returns verify recipient identity and current recognized cost. Original service counts distinguish encounters and nutrition recipients rather than claiming all contacts are unique treatment completions. Repeated visits, household duplication and clinical treatment completion are not verified. The modeled adult utility and actual net household resource effects are unsupported priors. Whole-recipient cost includes additional services and geography beyond this narrow adult medical channel. Original EIN 74-1951476 matches the AccessHealth recipient. Fort Bend and Waller clinical target is within the Houston MSA; service locations do not prove all patients reside there. Recipient-owned giving route is checked, not a transaction, funding restriction or donation-sensitive expansion.

4. What do you get for your dollar?

The conditional limited-channel annual reference is $12.6M per DALY: 2.91 clinical QALYs plus -0.365733 signed resource equivalents. $10,000 corresponds to 0.00 combined equivalents under proportional annual accounting, not verified next-gift response. Full recognized annual current expense is $32,035,425. Observed 51,493 encounters × judged .15 adult household opportunities per encounter × .2 additional annual response gives 1,544.79 exposed household proxies. The .15 mapping explicitly combines .25 distinct medical episodes per encounter with .6 adult-household share, neither observed. The clinical subset of 308.958 adults receives judged .02 utility for .5 finite years; this is not a trial-calibrated effect or visit-to-health conversion. Independent resource success .2 with hypothetical $200 actual otherwise-paid care expense avoided after alternative provider, taxes and benefits uses positive overlap .5 minus full $30 one-off copay, travel, childcare or foregone-pay burden. Success households net $70 and other exposed households lose full $30. One welfare-equivalent adult per household at $20,000 annual consumption is modeled with a single joint log. Retail 340B medicine value, gross wages and ordinary survivor earnings are excluded. Clinical failure retains resource exposures and burdens; positive-only overlap preserves full negative resources and union harms. ResourceYears means fraction of one year's gains, not repeated lifetime savings. Partner/payer opportunity costs are distinct from participant burdens; central external zero is unknown-neutral, not observed zero or complete world net benefit. Whole expense versus narrow adult medical numerator leaves other portfolio benefits, burdens and marginal financing unknown.

Model, assumptions and sensitivity

Whole annual recipient recognized resources; limited clinical/resource numerator; marginal additional cost unknown

Narrow Fort Bend/Waller adult medical channel inside Houston MSA; .95 local share is judgment, not inferred from five-county WIC coverage.

Union=N*unique*b; clinical=union*completion*q*discounted finite years minus full union harms. Financial=.5*people*discounted one-year log(1+joint net gain/baseline), local share once. Headline=10*C/(clinical+financial).

C
32035425 USD annual recognized resources (observed). FY2025 current recognized expense; prior-year adjustment excluded, no extra donated-service field identified. [services] [finance]
N
51493 annual medical encounters (observed). Original FY2025 MEDICAL ENCOUNTERS, not unique people, households or completed treatment. [services] [finance]
unique
0.15 adult household opportunities per medical encounter (judgment). Judged .25 episodes per encounter × .6 adult-household share = .15; no measured deduplication. [services] [finance]
b
0.2 incremental annual response share (judgment). Additional annual appropriate treatment after public/reimbursed alternatives, not next-gift multiplier. [services] [finance]
completion
0.2 clinical improvement share (judgment). Unsupported finite local prior, not empirically calibrated. [services] [finance]
q
0.02 QALY per person-year (judgment). Unsupported finite local prior, not empirically calibrated. [services] [finance]
T
0.5 finite clinical years (judgment). Unsupported finite local prior, not empirically calibrated. [services] [finance]
g
0.95 Houston MSA share (judgment). Unsupported finite local prior, not empirically calibrated. [services] [finance]
delay
0.25 years (judgment). Unsupported finite local prior, not empirically calibrated. [services] [finance]
discount
0.03 annual discount rate (judgment). Unsupported finite local prior, not empirically calibrated. [services] [finance]
success
0.2 additional resource success share (judgment). Unsupported finite local prior, not empirically calibrated. [services] [finance]
medicalGain
200 USD annual otherwise-paid care avoided (judgment). Unsupported finite local prior, not empirically calibrated. [services] [finance]
workGain
0 USD annual net disposable work resources (unknown). Unsupported finite local prior, not empirically calibrated. [services] [finance]
transferGain
0 USD annual net additional transfers (unknown). Unsupported finite local prior, not empirically calibrated. [services] [finance]
overlap
0.5 independent positive benefit share (judgment). Unsupported finite local prior, not empirically calibrated. [services] [finance]
cost
30 USD one-time incremental household burden (judgment). Unsupported finite local prior, not empirically calibrated. [services] [finance]
baseline
20000 USD annual household consumption (judgment). Unsupported finite local prior, not empirically calibrated. [services] [finance]
harm
0.00 QALY loss per exposed person (unknown). Unsupported finite local prior, not empirically calibrated. [services] [finance]
payerLoss
0 USD loss per resource success (unknown). Unsupported finite local prior, not empirically calibrated. [services] [finance]
payerPeople
100 distinct payer households (judgment). Unsupported finite local prior, not empirically calibrated. [services] [finance]
payerBaseline
50000 USD annual payer household consumption (judgment). Unsupported finite local prior, not empirically calibrated. [services] [finance]
externalCost
0 USD external loss per exposed household (unknown). Unsupported finite local prior, not empirically calibrated. [services] [finance]
resourceYears
1 fraction of one-year gains realized (judgment). Unsupported finite local prior, not empirically calibrated. [services] [finance]

central: Cost: $32.0M; Houston health QALYs: 2.91; all-population health QALYs: 3.07. Income-equivalent healthy years: -0.37. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

clinical null: Cost: $32.0M; Houston health QALYs: 0.00; all-population health QALYs: 0.00. Income-equivalent healthy years: -0.37. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

financial only: Cost: $32.0M; Houston health QALYs: 0.00; all-population health QALYs: 0.00. Income-equivalent healthy years: -0.37. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

current cost unknown: Cost: unknown; Houston health QALYs: 2.91; all-population health QALYs: 3.07. Income-equivalent healthy years: -0.37. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

full unknown: Cost: unknown; Houston health QALYs: unknown; all-population health QALYs: unknown. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

zero expansion: Cost: $32.0M; Houston health QALYs: 0.00; all-population health QALYs: 0.00. Income-equivalent healthy years: 0.00. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

true zero: Cost: $32.0M; Houston health QALYs: 0.00; all-population health QALYs: 0.00. Income-equivalent healthy years: 0.00. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

adverse: Cost: $32.0M; Houston health QALYs: -11.65; all-population health QALYs: -12.27. Income-equivalent healthy years: -5.54. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

positive net work: Cost: $32.0M; Houston health QALYs: 2.91; all-population health QALYs: 3.07. Income-equivalent healthy years: 1.44. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

no resource success: Cost: $32.0M; Houston health QALYs: 2.91; all-population health QALYs: 3.07. Income-equivalent healthy years: -1.09. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

no gains: Cost: $32.0M; Houston health QALYs: 2.91; all-population health QALYs: 3.07. Income-equivalent healthy years: -1.09. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

negative resource overlap zero: Cost: $32.0M; Houston health QALYs: 2.91; all-population health QALYs: 3.07. Income-equivalent healthy years: -3.30. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

negative resource overlap one: Cost: $32.0M; Houston health QALYs: 2.91; all-population health QALYs: 3.07. Income-equivalent healthy years: -3.30. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

mixed sign: Cost: $32.0M; Houston health QALYs: 2.91; all-population health QALYs: 3.07. Income-equivalent healthy years: -2.19. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

full payer incidence: Cost: $32.0M; Houston health QALYs: 2.91; all-population health QALYs: 3.07. Income-equivalent healthy years: -1.25. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

external provider cost: Cost: $32.0M; Houston health QALYs: 2.91; all-population health QALYs: 3.07. Income-equivalent healthy years: -1.85. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

annual full response: Cost: $32.0M; Houston health QALYs: 14.57; all-population health QALYs: 15.33. Income-equivalent healthy years: -1.83. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

half geography: Cost: $32.0M; Houston health QALYs: 1.53; all-population health QALYs: 3.07. Income-equivalent healthy years: -0.19. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

all unique: Cost: $32.0M; Houston health QALYs: 19.42; all-population health QALYs: 20.45. Income-equivalent healthy years: -2.44. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

zero resource duration: Cost: $32.0M; Houston health QALYs: 2.91; all-population health QALYs: 3.07. Income-equivalent healthy years: -1.09. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

two year health: Cost: $32.0M; Houston health QALYs: 11.48; all-population health QALYs: 12.09. Income-equivalent healthy years: -0.37. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

hypothetical alternative annual cost: Cost: $20.0M; Houston health QALYs: 2.91; all-population health QALYs: 3.07. Income-equivalent healthy years: -0.37. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

weak clinical: Cost: $32.0M; Houston health QALYs: 0.73; all-population health QALYs: 0.77. Income-equivalent healthy years: -0.37. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

Counterfactual: Insurance, Medicaid/Medicare, other FQHC and public/charity treatment, sliding fees, 340B access and partner funding remain baseline; only incremental annual care and net household resources count.

Attribution: Annual incremental recipient response is distinct from cohort deduplication and geographic share; no claim of whole annual portfolio or marginal donation causal effect.

Source-grounded cost and service description; numerical clinical and disposable-resource effects are unsupported conditional hypotheses. Complete total EV remains unknown.

Sensitivity

  • clinical null: no finite positive estimate. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • financial only: no finite positive estimate. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • current cost unknown: no finite positive estimate. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • full unknown: no finite positive estimate. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • zero expansion: no finite positive estimate. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • true zero: no finite positive estimate. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • adverse: no finite positive estimate. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • positive net work: $7.4M per DALY. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • no resource success: $17.6M per DALY. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • no gains: $17.6M per DALY. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • negative resource overlap zero: no finite positive estimate. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • negative resource overlap one: no finite positive estimate. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • mixed sign: $44.4M per DALY. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • full payer incidence: $19.2M per DALY. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • external provider cost: $30.0M per DALY. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • annual full response: $2.5M per DALY. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • half geography: $23.9M per DALY. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • all unique: $1.9M per DALY. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • zero resource duration: $17.6M per DALY. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • two year health: $2.9M per DALY. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • hypothetical alternative annual cost: $7.9M per DALY. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.
  • weak clinical: $88.3M per DALY. Conditional finite annual channel; full portfolio, current cost and marginal gift unknown.

Unresolved inputs

  • Unique adult patient households and treatment completion
  • Causal clinical utility and net household incidence versus alternatives
  • Unrecognized provider opportunity costs and broader service geography
  • Marginal donation capacity and complete portfolio outcomes

Health and income breakdown

For the modeled $32.0M: 2.91 health QALYs + -0.37 income-equivalent healthy years in Houston: $12.6M per DALY. Income equivalents are welfare comparisons, not observed QALYs or DALYs.

Method and caveats.

5. Funding and previous grants

Current fiscal year ends June 30, 2025. Original recognized current expenses are FY2025 $32,035,425, FY2024 $30,581,547 and FY2023 $27,842,283. FY2025 Schedule D audited expense $32,061,430 less $26,005 PRIOR YEAR ADJUSTMENT reconciles to $32,035,425; this is not an omitted donated-service expense or new current service cost. No populated netted event/rental/inventory or excluded donated-service fields were recovered; unrecognized volunteer/partner resources remain unknown, not factual zero. Reimbursements, public grants, 340B and WIC funding are baseline mechanisms; donations are not assumed to create all existing services.

Annual expenses

Organization-level spending, including programs, administration and fundraising. The research list averages three comparable, consecutive full fiscal years when available.

  • FY 2023: $27.8M; org:accesshealth, 12-month period, Current recognized annual expense excluding prior-year-only reconciliation adjustments. Source
  • FY 2024: $30.6M; org:accesshealth, 12-month period, Current recognized annual expense excluding prior-year-only reconciliation adjustments. Source
  • FY 2025: $32.0M; org:accesshealth, 12-month period, Current recognized annual expense excluding prior-year-only reconciliation adjustments. Source

6. Sources

  1. Current FQHC services, fee and pharmacy mechanisms. AccessHealth. Published: not stated; retrieved: 2026-10-05.
  2. Original FY2025 Form 990, medical encounters and expense. IRS. Published: not stated; retrieved: 2026-10-05.
  3. Original FY2025 Schedule D prior-year expense adjustment. IRS. Published: not stated; retrieved: 2026-10-05.
  4. Original FY2024 Form 990. IRS. Published: not stated; retrieved: 2026-10-05.
  5. Original FY2023 Form 990. IRS. Published: not stated; retrieved: 2026-10-05.
  6. Current official donation route. AccessHealth. Published: not stated; retrieved: 2026-10-05.
  7. Coefficient Giving income welfare conversion. Coefficient Giving. Published: not stated; retrieved: 2026-10-05.