eConsults reduce out-of-pocket costs for patients
By Dereck Tatman, President of AristaMD, March 2018.
In 2016, U.S. healthcare spending increased by 4.3 percent, reaching a high of $3.3 trillion. This cost burden affects everyone across the spectrum of care. One growing trend intended to reduce overall healthcare costs is a shift to high-deductible health plans, with many patients responsible for paying more in out-of-pocket costs than ever before. According to Kaiser Family Foundation, consumer out-of-pocket spending rose at six times the rate of wages over the past 16 years. Patient out-of-pocket spending now accounts for 30 percent of healthcare revenue. For instance, a patient is typically responsible for $300 of a $1,000 hospital bill.
Patients with high deductible plans are most likely to avoid seeking the care they need due to expensive out-of-pocket costs. According to the National Health Center for Statistics, almost 40 percent of the population ages 18 to 64 have high deductible health plans. By forgoing necessary care to save money, many patients’ conditions deteriorate to the point where they require a higher degree of care (including hospitalization), resulting in higher out-of-pocket costs and additional costs to payers and health systems. This dynamic is unacceptable and must be addressed within the shift to value-based care.
eConsults offer an ideal solution for patients with this type of coverage, providing immediate access to specialty care in the primary care office without additional out-of-pocket spend. Here are three specific ways in which eConsults are reducing costs for patients:
- Increased access to specialty care.
New technology now allows for specialists to collaborate with PCPs to remotely diagnose and monitor the health conditions of patients requiring specialty care. Through electronic consults, or eConsults, PCPs have access to specialists with whom they can share all relevant patient data and receive care plan recommendations in a matter of hours. Electronic collaboration between providers can deliver more timely access to quality care, while avoiding the need for most patients to see a specialist in person.
In addition, eConsults are a valuable tool to help ensure that the most serious patient cases are triaged to in-person specialist visits, while lower acuity patients are safely treated by their PCP with the input of a specialist. This triaging decreases the wait times that are typically faced when trying to access specialty care, while at the same time increasing the overall access to specialty care.
- Reduced cost of care.
Access to specialty care within the primary care setting via eConsults reduces expensive specialist visits and patient costs related to travel and out-of-pocket expenses. Utilizing eConsults in a primary care practice ensures that patients in need of specialist input are matched with the most appropriate modality of care, for the right patient, at the right time, decreasing overall healthcare spend.
- Improved health outcomes.
The days of waiting months for a specialist visit for a longstanding or deteriorating condition are over. PCPs supported by specialists through eConsults leads to near immediate patient care, which reduces ER visits and subsequent hospitalizations. This improvement in care reduces patient costs and requires no additional training of PCPs.
As healthcare spending continues to increase, all stakeholders must look at innovative ways in which to incorporate new solutions into general healthcare practices to alleviate not only operational costs of care, but the out-of-pocket expenses being shouldered by the patient. eConsults help avoid unnecessary patient costs, while ensuring optimal care. Providers utilizing eConsults are able to deliver quality care at a lower overall cost, while also providing convenience to patients and improving healthcare efficiency.