Reimbursement and Policy
The E-Consult Workgroup Celebrates Primary Care Provider E-Consult Reimbursement by California Department of Health Care Services
LARKSPUR, Calif. – November 21, 2024 – The E-Consult Workgroup, a California Health Care Foundation-supported collaborative of managed care plans, health systems, and patient and provider associations educating and advocating for e-consult use, today announced it applauds the recent decision by the California Department of Health Care Services (DHCS) to expand reimbursement to cover treating providers’ time…
Read MoreTelemedicine and the Environment
Stanford Health Care (SHC) examined the environmental impact of in-person and virtual clinic visits from 2019 to 2021. Despite a 13% rise in clinic visits, SHC experienced a notable 36% decrease in greenhouse gas (GHG) emissions, mainly due to expanded telemedicine services. Telemedicine helped SHC avoid about 17,000 metric tons of GHGs in 2021 alone.…
Read MoreTelehealth Cuts Health Care’s Carbon Footprint and Patient’s Costs
UC Davis and four other University of California health care systems and doctors used telehealth to serve their patients and tracked this data over the first two years of the pandemic. The video visits that took place saved substantial time, carbon emissions, and transportation costs. These savings included eliminating the need to commute 53,664,391 miles –…
Read MoreCenter for Medicare & Medicaid Services Announces Increased Flexibilities in Medicaid E-Consult Reimbursement
On January 5, 2023, CMS published a State Health Official letter clarifyingpolicy on reimbursement for interprofessional consultation services inMedicaid and CHIP. The letter outlines that interprofessional consultation isa distinct, coverable service in Medicaid and CHIP, and that payment can bemade directly to consulting providers. This welcomed change will bringclarity to states in adding interprofessional consultation…
Read MoreCenters for Medicare and Medicaid Services Support for E-Consult Reimbursement
In December, the Association of American Medical Colleges (AAMC) and Virginia Medicaid (Department of Medical Assistance Services) met with the Centers for Medicare and Medicaid Services to discuss Medicaid’s payment policies with a focus on new concerns that have been raised in some states about the ability of Medicaid to provide a federal match for…
Read MoreE-Consult Workgroup Newsletters
E-Consult Coalition News August 2023 E-Consult Coalition News July 2023 E-Consult Coalition News June 2023 E-Consult Coalition News May 2023 E-Consult Coalition News April 2023 E-Consult Coalition News March 2023 E-Consult Coalition News February 2023 E-Consult Coalition News January 2023 Part 2 E-Consult Coalition News January 2023 Part 1 E-Consult Coalition News December 2022 E-Consult…
Read MoreE-Consult Workgroup 2020 Annual Meeting Highlights
The E-Consult Workgroup and California Telehealth Policy Coalition hosted our annual meetings November 16-17, 2020. Thank you to our speakers and sponsors of our annual meeting, made possible by California Health Care Foundation, Anthem Blue Cross, ConferMed, IEHP, Safety Net Connect, WISE Healthcare, AristaMD, and RubiconMD. To sponsor the Workgroup in 2021, contact econsultworkgroup@bluepathhealth.com. View Fireside…
Read MoreSeptember 2021 Central Valley E-Consult Coalition Meeting
Septmeber’s webinar featured the launch of the CAPP child and adolescent psychiatry e-consult program, presented by Petra Steinbuchel, MD and Michelle Riederer, MD, UCSF Benioff Children’s Hospitals. In addition, we shared upcoming opportunities including free CME on e-consult for behavioral and mental health, and access to e-consults for uninsured patients.
Read MoreClinical Trends Over the First Year of a Psychiatric Electronic Consult Service
This study aims to determine which psychiatric diagnoses are most commonly used for e-consults inquiries, what types of questions are being asked by primary care providers to psychiatrists via e-consults, and what questions and which diagnoses result in a recommendation for in-person evaluations by psychiatrists. The study found that certain diagnoses and question types appear to influence…
Read MoreE-Consult for Rural Neurology
A new study explores he demand for neurology services at Geisinger, which exceeds the current clinical capacity. The utility of Ask-a-Doc (AAD), an electronic medical record-based interface developed at Geisinger to facilitate communication between primary care physicians (PCPs) and specialists, was implemented and assessed. It was found that AAD provides an interface between PCPs and…
Read MoreCHCF Publication on Post-Pandemic Federally Qualified Health Center Telehealth Reimbursement
California Health Care Foundation recently released a piece titled “Reimbursing FQHCs for Telehealth Post-COVID-19 Pandemic: Medi-Cal’s Options”. The publication addresses needs to continue to support the much-needed telehealth services that have been spearheaded by FQHCs in response to COVID-19. Rafael A. Gomez, Pacific Health Consulting Group, mapped out recommendations including: Exploring prospective payment system (PPS)…
Read MoreCalifornia SB365 Supports Primary Care Provider E-Consult Reimbursement
Senator Anna M. Caballero, 12th Senate District, California, has sponsored a bill requiring Medi-Cal to reimburse all participating primary care providers, including those who operate out of a federally qualified health center (FQHC) or rural health clinic (RHC) for e-consult services. Read SB 365 bill language here. To sign the E-Consult Workgroup letter of support for…
Read MoreFAQ’s for Managed Care Organizations E-Consult Programs
FAQs for education of State agencies on e-consult.
Read MoreProposed Changes to CMS Physician Fee Schedule for 2021
Medicare provider fee schedule including e-consult CPT codes (99446-9 and 99451-2). https://www.cms.gov/newsroom/fact-sheets/proposed-policy-payment-and-quality-provisions-changes-medicare-physician-fee-schedule-calendar-year-4
Read MoreCMMI E-Consult CORE Program
CMMI Project CORE: Coordinating Optimal Referral Experiences https://www.aamc.org/what-we-do/mission-areas/health-care/project-core
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