Addressing Policy Barriers to E-Consult Adoption and Reimbursement in California

E-consult is a care delivery mode that significantly improves specialty care access for the safety-net by enabling primary care providers to communicate directly with specialists about patient needs using telehealth technology. Studies, such as one published in Health Affairs about LA County, show significant success in decreasing patient wait times to see specialists, such as cardiologists, neurologists and gynecologists. However, as with many new telehealth-based care delivery modes, despite e-consults’ success barriers impeded its adoption.

To overcome these barriers and expand adoption of e-consult, the Center for Connected Health Policy (CCHP) partnered with the California Healthcare Foundation and the Blue Shield of California Foundation to form the Electronic Consult Workgroup. In March 2016, CCHP partnered with BluePath Health to establish the Workgroup’s membership of providers, payers, policy makers and patient advocates, facilitate monthly meetings and support provider grantees’ implementation of e-consult. The Workgroup’s goal is to outline and address regulatory and policy barriers, as well as to provide recommendations for accelerating e-consult’s expansion throughout the state.

This ongoing work includes:

  • Setting agendas, facilitating and summarizing monthly webinar meetings of the Electronic Consult Workgroup.
  • Creating and leading Workgroup subcommittees on reimbursement policy and fiscal analysis of e-consult implementations and payers.

Results

E-consult is a store-and-forward, or asynchronous, telehealth mode that supports communication on patient care between primary care providers and specialists.