Expanding timely access to specialty care for the underserved through the improvement of the policy environment governing the use of and financial support for eConsult in California.
Timely access to specialty care is a serious issue, particularly for the state’s rural and underserved. With 3.4 million newly insured, this issue has worsened.
The use of electronically delivered services is one way to help alleviate demand and improve quality. eConsult is a web-based system that allows a primary care physician (PCP) and a specialist to securely share health information and discuss patient care. This physician to physician electronic consultation reduces the need for unnecessary specialty referrals as patient’s needs are resolved through the PCP. Additionally, the time saved reduces costs and the PCP is also able to build capacity and directly treat patients who often are referred to a specialist for common conditions.
Blue Shield of California Foundation (BSCF) recently launched an electronic consult initiative among several California safety-net providers. Readying them to adopt these new technologies at scale will require a comprehensive assessment of federal and state policies, including reimbursement, privacy and security, access, quality and other performance thresholds. To aid in this, CCHP has received funding from BSCF and the California Health Care Foundation to develop a comprehensive plan that outlines regulatory and policy barriers and will provide recommendations to accelerate the expansion of eConsult throughout the state. In addition, reimbursement models will be developed that can be used to forecast visit pattern changes and calculate potential savings. The models will be built in collaboration with the initiative providers and their respective payers, and can be used to track implementation. To accomplish this, CCHP has partnered with BluePath Health, a consultant firm with particular expertise in this field.