The Primary Cares Initiative provides new value-based payment models aiming to enhance the delivery of primary care to promote efficiency and quality while decreasing healthcare costs. In the second part of this two-part blog series, we explore how eConsults directly support this new initiative across several key metrics.
IntroductionThe Primary Cares Initiative represents the most recent push for enhancing primary care within health care systems, alongside previous models such as Patient-Centered Medical Home (PCMH), the Comprehensive Primary Care (CPC+) program, and the Medicare Advantage Value-based Insurance Design (VBID). Yet as programs continue to emphasize primary care providers as a locus of optimal care, the question becomes: how can PCPs best work within initiatives such as this to enhance care delivery efficiency and effectiveness and what kinds of services and technologies can support this? A clear answer lies within telehealth technologies, such as eConsults, which is an asynchronous peer-to-peer platform that directly supports primary care capabilities by improving appropriate access to specialist care and improving healthcare outcomes for low- and high-acuity patients alike.
eConsults directly support the Primary Cares Initiatives by maximizing primary care’s value in healthcare delivery, having demonstrated direct benefits in terms of outcomes, costs, and both patient and provider satisfactionA continuing challenge in maximizing the efficiency and effectiveness of primary care relates to specialist referrals. As more health systems look toward creating PCMH models and consider adopting new value-based payment models under the Primary Cares Initiative, eConsult platforms will be instrumental in improving team-based care coordination and communication. AristaMD and other leading telehealth companies have contributed to the growing body of evidence to demonstrate the benefits of eConsults and other emerging technologies in the healthcare. Various sources of data and testimonial showcase improved performance of hospitals and health care systems along several key metrics as a result of implementing these technologies. Reduced costs When it comes to increasing efficiency under the Primary Cares Initiative, a crucial aim is to reduce costs—for both healthcare organizations and patients—without sacrificing quality of care. Empowering primary care clinics to retain patients and treat them within the offices of PCPs yields greater savings for all stakeholders. An eConsult cost savings analysis demonstrated that $75 billion is spent annually on specialist referrals in the U.S. based on the following data:
- 9% of ambulatory visits result in a specialist referral; one in three hospital discharges result in referrals to other care providers
- The average referral results in 4 specialist visits
- $965 is the average total downstream specialist costs resulting from one referral
- In a subset survey from 1,743 eConsults, surgery yield (percent of ambulatory visits resulting in a scheduled surgical case) increased by 11% (p=0.07) compared to standard care in a one-year retrospective study
- eConsults led to statistically significant reduction in avoidable surgical follow-ups in a two-year prospective pre-post survey analysis
- eConsults led to modified diagnosis in 15% of cases, and treatment plan change in 24% of cases in a one-year prospective data review of pediatric eConsults
- In terms of clinical care outcomes, one study found eConsults reduced time to complete a hematuria workup by more than 50%.
- Star Measures C22 (Getting Needed Care) and C23 (Getting Appointments and Care Quickly)
- Star Measure C27 (Care Coordination (CAHPS))
- Star Measure C21 (Plan All-Cause Readmissions Healthcare Effectiveness Data and Information Set (HEDIS))