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Health Aff (Millwood). 2018 Dec;37(12):2031-2036. doi: 10.1377/hlthaff.2018.05124.

Reduced Cost Of Specialty Care Using Electronic Consultations For Medicaid Patients.

Author information

1
Daren Anderson ( Daren@chc1.com ) is director of the Weitzman Institute at Community Health Center Inc., in Middletown, Connecticut.
2
Victor G. Villagra is an assistant professor at the UCONN Health Disparities Institute, University of Connecticut Health Center, in Farmington.
3
Emil Coman is a research associate in the Ethel Donaghue Center for Translating Research into Practice and Policy, University of Connecticut Health Center, in Farmington.
4
Tamim Ahmed is president of Health Analytics LLC, in Glastonbury, Connecticut.
5
Anthony Porto is a research assistant at the Weitzman Institute, Community Health Center Inc.
6
Nicole Jepeal is a quality improvement analytics supervisor at CareOregon Inc., in Portland. She was a research associate at the Weitzman Institute, Community Health Center Inc., at the time this work was conducted.
7
Giuseppe Maci is a research associate at the Weitzman Institute, Community Health Center Inc.
8
Bridget Teevan is a public health epidemiologist in the Rhode Island Department of Health, in Providence. She was a research associate at the Weitzman Institute, Community Health Center Inc., at the time this work was conducted.

Abstract

Specialty care accounts for a significant and growing portion of year-over-year Medicaid cost increases. Some referrals to specialists may be avoided and managed more efficiently by using electronic consultations (eConsults). In this study a large, multisite safety-net health center linked its primary care providers with specialists in dermatology, endocrinology, gastroenterology, and orthopedics via an eConsult platform. Many consults were managed without need for a face-to-face visit. Patients who had an eConsult had average specialty-related episode-of-care costs of $82 per patient per month less than those sent directly for a face-to-face visit. Expanding the use of eConsults for Medicaid patients and reimbursing the service could result in substantial savings while improving access to and timeliness of specialty care and strengthening primary care.

PMID:
30633678
DOI:
10.1377/hlthaff.2018.05124

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