By Brooke LeVasseur, October 2017
The U.S. health system today is facing unprecedented demands – from decreasing reimbursements to ever-changing regulations to the transition from fee-for-service reimbursement to value-based care models. Yet, amidst it all, healthcare stakeholders still need to achieve the holy grail of healthcare: higher quality care — at lower costs — with greater access for all patients. Telehealth software may lead to the completion of this quest.
In study after study, telehealth has demonstrated great potential for solving that multidimensional dilemma, especially for our country’s most vulnerable populations, such as the poor, elderly, rural and those suffering from chronic conditions.
Particularly promising are physician-to-physician electronic consultations (eConsults). These asynchronous, consultative communications take place within a secure, web-based platform through which physicians share materials such as medical records, scans, x-rays and notes. Specifically, physician-to-specialist eConsults offer an opportunity to quickly and easily increase access to specialty care among underserved populations, which frequently have considerable difficulty in obtaining specialty care.
Why access to specialty care is such a challenge for Medicaid patients
The barriers that Medicaid patients face in accessing specialty care are substantial and daunting. Most significantly, Medicaid’s lower reimbursement rates result in fewer specialists accepting Medicaid patients, and those who do often limit the number that they’ll schedule.
Further, even when Medicaid patients find themselves fortunate enough to obtain an appointment with a specialist, many face obstacles in affording or finding transportation and childcare. The unfortunate outcome is long wait times for appointments, reduced access to care and deteriorating health for Medicaid patients unable to get the specialty care they need, according to the Center for Studying Health System Change.
There’s little question that the Medicaid population has a serious need for greater access to specialty care. Thus, it has become essential that we explore additional investment in telehealth, in general, and eConsults between primary care physicians (PCPs) and specialists, specifically, as a means of connecting underserved populations to specialists.
With eConsults, Medicaid patients can experience a higher quality of care by extending the capabilities and efficiencies of PCPs, who treat the widest variety of patients. Another benefit of eConsults is that they enhance patient satisfaction by enabling patients to receive specialty care without the need to leave the comfort, security and convenience of their own PCP’s office.
Medicaid patients today, the rest of us tomorrow
While some may dismiss the significant challenges that Medicaid patients face in accessing specialty care as just another indignity suffered by those with lower incomes, it’s a problem that may begin to climb its way up the economic ladder in the coming years.
More and more specialists, from cardiologists to orthopedic surgeons and plenty of others, are likely to find themselves stretched increasingly thin as the U.S. suffers the fallout from a specialist shortage that is predicted to range between 28,000 and 64,000 by 2025, according to the Association of American Medical Colleges.
And just at the time when the U.S. health system is lacking an adequate number of specialists, the system is relying more heavily upon them, as a study in the Archives of Internal Medicine illustrated. Between 1999 and 2009, the probability that an ambulatory visit to a physician resulted in a referral to another physician rose from 4.8 percent to 9.3 percent, the study found, representing an increase of 92 percent.
Although the quest for improved healthcare will continue throughout the foreseeable future, telehealth offers a proven path to the hidden treasures of enhanced care quality, access and cost efficiencies. Now it’s up to healthcare stakeholders nationwide to invest further in advanced telehealth technologies and physician-to-physician eConsults in order to bring the nation’s most vulnerable patients, as well as the rest of us, along the journey toward better patient outcomes.