RT Journal Article
SR Electronic
T1 Evaluating the Impact of an eConsult Platform on Specialty Care Access for Medicaid Patients
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
DO 10.3122/jabfm.2024.240322R1
A1 Thind, Birpartap S.
A1 Maddalena, Moriah
A1 Baqai, Waheed
A1 Frencher, Stanley K.
A1 Jih, William W.
YR 2025
UL http://www.jabfm.org/content/early/2025/08/22/jabfm.2024.240322R1.abstract
AB Background: Healthcare access disparities persist, particularly among Medicaid patients in regions like the Inland Empire, California. These patients often face prolonged wait times for primary and specialty care, compounded by difficulties in scheduling with providers. Leveraging eConsult platforms offers a potential solution to improve specialist care accessibility. This study examines the impact of the Inland Empire Health Plan's (IEHP) eConsult services on enhancing interactions between primary care providers (PCPs) and specialists and improving patient care.Methods: We analyzed 2,505 eConsults conducted between January and June 2022 within the IEHP, focusing on dermatology, pulmonology, and urology. Each eConsult was categorized based on closure outcomes, advice provided, and authorization status. We cross-referenced eConsult data with claims and authorization records to determine encounter completion, particularly whether a face-to-face specialist visit occurred.Results: Only a fraction of eConsults (27% dermatology, 25% pulmonology, 37% urology) resulted in specialist advice. In cases where eConsults did not suffice, specialists recommended in-person follow-up; however, a significant portion of patients (57% dermatology, 71% pulmonology, 53% urology) did not receive in-person specialty care.Conclusion: This study highlights the potential of eConsults in improving specialty care access for Medicaid patients in underserved regions. While eConsults show promise in expediting specialist access, challenges such as varying PCP utilization and the need for in-person visits persist. Addressing these issues with standardized protocols and better triaging can significantly reduce healthcare disparities and improve patient outcomes.