Researches at Community Health Center and the University of Connecticut Health center conducted the first randomized controlled trial of eConsults for cardiology and demonstrated the reduction of total healthcare costs for Medicaid members’ care. The cost savings demonstrated in this study will support state Medicaid agencies, payers, and other health systems seeking new ways to improve access and quality while reducing telemedicine consults cost. Policy changes that support the use of eConsults as a new service modality could result in significant savings to the Medicaid program in a relatively short time frame.
The telemedicine consults platform eConsult, yielded lower mean adjusted total costs of $655 per patient, or lower mean costs of $466 when adjusted for non-normality, compared to those using face-to-face consults over a six-month span. In addition, the eConsult group reported reduced costs of $81 per patient for outpatient cardiac procedures, as well as improving access to care for underserved patients and reducing the rate of no-shows for providers. The results of this study
“The results of our analysis show for the first time that when [primary care providers] are given an option to use eConsults for Medicaid beneficiaries, the total costs and the cost of outpatient cardiac tests and procedures at 6 months are significantly lower, by $466 and $81, respectively, compared with the traditional [face-to-face] approach,” the study, highlighted in the January issue of the American Journal of Managed Care, reported.
Telemedicine Consults
The study was conducted by a team led by Daren Anderson, MD, CHC’s vice president and chief quality officer and director of the Weitzman Institute, CHC’s research and innovation arm, both based in Middletown, Conn.
For their study, Anderson and his colleagues drew data from 235 Medicaid patients receiving face-to-face cardiac care treatment and 134 involved in the eConsult program.
In the eConsult group, 59 were referred for face-to-face consults due to the urgency of their condition or an established relationship with a cardiologist. Of the rest, which were referred to a reviewing cardiologist on the virtual care platform, 54, or 72 percent, didn’t require a specialty consult and were treated by the PCP, who received some guidance through the eConsult platform.
In the control group, 196 of the 235 patients, or 83 percent, had a face-to-face visit with a cardiologist; of the other 39 patients, 24 were no-shows.
While pointing out the value of the eConsult platform to healthcare providers and their patients, the study also noted that changes need to be made for the program to continue its success.
Anderson and his fellow researchers concluded that the eConsult platform can be valuable to state Medicaid agencies and health systems seeking ways to improve healthcare access for the underserved while reducing costs.
“Policy changes that support the use of eConsults as a new service modality could result in significant savings to the Medicaid program in a relatively short time frame,” they noted. “However, sustaining eConsult programs will require changes in reimbursement policies, either by authorizing payments for eConsults on a fee-for-service basis or by increasing the opportunities for primary care and specialty providers to share in the savings that accrue from more efficient and effective care.”
Addording to the report, sustaining eConsult programs will require changes in reimbursement policies, either by authorizing payments for eConsults on a fee-for-service basis or by increasing the opportunities for primary care and specialty providers to share in the savings that accrue from more efficient and effective care. Future studies should examine the cost–benefit balance of eConsults for multiple specialties and in more diverse settings to further inform these policy changes as well as which changes in costs trigger changes in other costs. Longer follow-up will also be useful to determine the durability of savings realized in the short term.
