Could Telemedicine Connect More Medicaid Patients With Specialty Care?

For any patient, the world of specialty care can be a challenging one to navigate. That can be particularly true for Medicaid patients in need of specialist care, given that they often face long waits for appointments, with a limited pool of providers willing to treat them—and it’s even true for those enrolled in managed care programs that include specific access standards for specialty care. But the positive results that the use of one online platform has shown among Medicaid patients could serve as a model. As mHealth Intelligence first reported, a recent editorial published in JAMA Internal Medicine asserted that telemedicine could go a long way toward more effectively connecting Medicaid patients with specialty providers. “These alternative type of consultations allow patients to receive rapid specialty advice without the need for traveling and typically at lower cost,” Dr. Mitchell Katz, based at the Los Angeles Department of Health Services, writes.

Some states (as we noted earlier this year) are already utilizing a platform called eConsult, with largely successful results. Developed in Connecticut at the state’s Community Health Center, eConsult allows primary care physicians to easily communicate online with specialists about the necessity of patient referrals. It’s now in use with Medicaid providers in nine states; notably, providers can also receive reimbursement from the Centers for Medicare and Medicaid Services (CMS). For his part, Katz points to reimbursement as a particular challenge for telemedicine providers. “For these visits to be financially sustainable, the provider must be in a capitated system or there must be billing codes for such visits,” he notes.

The inspiration for Katz’s editorial stems in part from the results of a recent study, also published in JAMA Internal Medicine, that examined the degree to which state access standards helped Medicaid managed care enrollees get timely access to specialty providers. Researchers from the Yale School of Public Health found that the standards “did not lead to widespread improvements in access to specialist physicians.” One possible explanation for this was a lack of enforcement. What’s more, in the researchers’ view, “Meaningful improvements in access to specialty care for Medicaid recipients may require additional interventions.” The way Katz and others see it, telemedicine—and specifically, the eConsult platform—could be just such interventions.

Click here to read the article from mHealth Intelligence on the eConsult platform.

Click here to read the editorial from JAMA Internal Medicine on telemedicine and Medicaid patients.

Click here to read the abstract of the Medicaid specialty care study from JAMA Internal Medicine


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