CMS Approves Medicaid Reimbursement for eConsults in Connecticut

MIDDLETOWN, Conn: The Centers for Medicare and Medicaid (CMS) have approved payment by Medicaid to federally qualified health centers in Connecticut for electronic consultations (eConsults) with medical specialists, giving the state’s medically underserved population greater access to expert care.

Connecticut is the first state in the nation to obtain Medicaid reimbursements for eConsults.

“This is good news for our patients and for our primary care providers,” said Daren Anderson, MD, director of the Weitzman Institute, the research and quality improvement arm of Community Health Center, Inc. (CHC). “Use of eConsults can improve access to care and promote better communication between primary care providers and specialists,” he said.

Anderson and the Weitzman Institute studied the use of eConsults for CHC patients in Connecticut over the course of one year. “We found eConsults effective at increasing access to specialty care for underserved populations, reducing the need for face-to-face specialty care, streamlining specialty referrals and potentially reducing emergency department use,” said Anderson. The study will appear in the March-April issue of the Annals of Family Practice, available March 7.

Based on the positive research, Anderson worked with the Department of Social Services to obtain Medicaid reimbursement for the eConsults service. The state agency submitted the request to CMS, which approved it on Feb. 16.

According to Anderson, there is a scarcity of specialty providers willing to see Medicaid patients , creating a lead time for appointments that can be as long as a year. “Inadequate access to care is a significant contributor to healthcare disparities, higher rates of disability, and complications in chronic diseases,” said Anderson.

CHC has begun contracting with state and federal agencies, as well as private insurers, to provide eConsults to medically underserved patients across the U.S.

“As an organization devoted to providing high quality primary care to the underserved, we are focused on establishing new benchmarks for both quality and efficiency,” said Mark Maselli, CEO of CHC. “We believe eConsults is another example of our leadership in transforming the delivery of primary care locally and nationally.”

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About Community Health Center, Inc. Since 1972, Community Health Center, Inc. has been one of the leading healthcare providers in the state of Connecticut, building a world-class primary healthcare system committed to caring for uninsured and underserved populations. CHC is focused on improving health outcomes for its more than 130,000 patients as well as building healthy communities. Recognized as both a Level 3 Patient-Centered Medical Home by the National Committee for Quality Assurance and a Primary Care Medical Home by The Joint Commission, CHC delivers service in more than 200 locations statewide, offering primary care in medical, dental and behavioral health services. For more information, visit www.chc1.com.

About The Weitzman Institute The Weitzman Institute is the research and innovation arm of Community Health Center, Inc., dedicated to inspiring primary care innovation and improving health outcomes for the medically underserved. With its expertise in quality improvement, the Weitzman Institute is partnering with organizations around the globe to transform the primary care delivery system through research, training and education. For more information, visit www.weitzmaninstitute.org.

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