eConsult Program Analysis: Save $3M in Annual Referral Costs

November 30, 2018

TOPICS: Cost-of-Care
eConsult program analysis: Save $3M in annual referral costs

Wondering what your organization’s ROI could be by leveraging an eConsult program? Learn more about why innovation is essential within the transition to value-based care, and what your telehealth cost savings could be through an in-depth analysis of how eConsults reduce unnecessary spending while improving access to quality care.

Within the shift from fee-for-service payment models to value-based care, it has become increasingly important for healthcare providers to focus on optimizing the referral process and referring patients to the right place at the right time. Health plans are missing out on critical programs to support this transition. An assessment of telehealth cost savings is essential when assessing tools and resources to support organizational goals.

In addition to increasing access to quality specialty care, eConsult cost savings result from decreased healthcare spending stemming from unnecessary referrals, chronic disease management, and high-risk patients.

An eConsult program within the overall cost of care

National health expenditure growth is expected to average 5.5 percent annually over 2017-2026, according to a report published today as an “Ahead Of Print” by Health Affairs and authored by the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS). Growth in national health spending is projected to be faster than projected growth in Gross Domestic Product (GDP) by 1.0 percentage points over 2017-2026. As a result, the report projects the health share of GDP to rise from 17.9% in 2016 to 19.7% by 2026.

  • 9% of ambulatory PCP visits result in a specialist referral
  • 20-30% of these referrals are for routine clinical issues that can be safely treated by PCPs *Source: AristaMD internal data, 2018
  • The average referral results in 3.4 specialist visits
  • Average total cost of downstream specialist costs resulting from one referral is $965
  • About one in 10 ambulatory visits and one in three hospital discharges will result in referrals to other care providers
  • Two out of every three Medicare beneficiaries have two or more chronic diseases, which often requires treatment from multiple providers in multiple specialties


eConsults reduce health plan costs and deliver increased access to specialty care

The adoption of an eConsult program is fast and simple. It immediately gives PCPs support in order to avoid unnecessary referrals.

  • Deliver more timely access to care
  • Reduce costs associated with unnecessary specialist visits, labs, and diagnostics
  • Improve patient satisfaction
  • Minimize costs such as extra or unnecessary ED and office visits associated with waiting for specialist availability

An eConsult program can reduce health plan costs and deliver increased access to specialty care


Health plans could be capturing $3 million per year in telehealth cost savings, for every 100,000 members.

We’ll Calculate Your ROI on Telehealth Using eConsults

With $0 upfront costs or implementation fees, you don’t need to create a new budget to run an eConsult program. You’re already paying for specialist visits. Use our ROI calculator to see how much we can save you.


1NAMCS 2015: Rui P, Okeyode T. National Ambulatory Medical Care Survey: 2015
2Barnett et al; Arch Intern Med. Author manuscript; available in PMC 2013 February 09
3MEPS (Medical Expenditure Panel Survey): STATISTICAL BRIEF #484: Expenses for Office¬-Based Physician Visits by Specialty, 2013