Article: Congress Mulls Federal Support for Specialist Consults Via Telehealth

Article originally published at MHealthIntelligence by Eric Wicklund

As proposed, the Specialty Treatment Access and Referrals (STAR) Act would establish a grant program to help healthcare providers develop and launch an eConsult platform.

October 25, 2019 – Congress will soon debate a new bill aimed at supporting telehealth programs that facilitate specialist consults.

California Congressman Josh Harder has announced plans to submit the Specialty Treatment Access and Referrals (STAR) Act, which would create a federal grant program to help healthcare providers launch an eConsult platform. The connected health service enables primary care providers to schedule specialty consults for patients or connect with a specialist for clinical support.

Harder’s bill will be co-sponsored by Reps. Don Young of Alaska and Jeff Fortenberry of Nebraska.

“In our rapidly changing world, technology has evolved significantly, and health care delivery should be advancing along with it,” Young said in a joint press release. “Rural communities – particularly in Alaska – can greatly benefit from increased access to telehealth services, and we should be supporting this technology to help expand to patients across the country. I am proud to cosponsor the STAR Act to work toward bringing down health care costs and delivering the personalized, patient-centered care Alaskans deserve.”

“One of the toughest healthcare challenges we face in this country involves how to provide quality care to individuals and families living in areas that have comparatively few healthcare practitioners,” Mary R. Grealy, president of the Healthcare Leadership Council, added in the press release. “Congressman Harder’s legislation to advance telehealth capabilities will extend the scope of our healthcare workforce and, in so doing, provide greater access to care for those who are currently underserved. We applaud his vision in addressing this critically-needed aspect of our healthcare infrastructure.”

eConsults are generally designed to improve access to specialty care for underserved populations and give primary care providers clinical-based support to care for their patients. In some cases the PCP coordinates the consult for a patient, while another model connects the PCP with the specialist for guidance in treating that patient.

In 2015, Daren Anderson, MD, vice president of Connecticut-based Community Health Center, Inc. and director of the Weitzman Institute, a community-based research center founded to help federally qualified health centers improve primary care services for the underserved, launched an eConsult program targeting safety net populations.

Within a year, Anderson reported a 90 percent success rate in using the platform to facilitate consults, leading the Centers for Medicare & Medicaid Services to establish reimbursement for eConsults through the state’s Medicaid program.  

Two years later, Anderson and his colleagues published results of a study in the American Journal of Managed Care which found that an eConsult program for cardiac care patients 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.

eConsult programs are now up and running in several states, though adoption is slow, primarily due to reimbursement issues.

“Rural communities often lack easy access to health care providers, particularly for mental health. Expanding telehealth systems can close this rural-urban gap,” Fortenberry said in the press release. “It’s why I cosponsored the STAR Act, so rural communities don’t have to choose between health care and their way of life.”

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