More E-Savvy For Medi-Cal Plans
Two Medi-Cal managed care plans in Southern California have launched ambitious e-health initiatives both hope will help keep a lid on rising healthcare costs.
L.A. Care Health Plan is focused on reducing unnecessary visits to medical specialists, while the Inland Empire Health Plan wants to better manage chronic conditions such as diabetes.
L.A. Care’s Web-based eConsult portal allows the health plan’s primary care and specialty physicians to directly communicate within one another, including the sharing of photos and other documentation. That permits more thorough patient evaluations prior to making a referral to a specialist.
Pilot project testing of the platform reduced referrals in some specialty categories by as much as 48%. That’s a significant money-saver, considering an unnecessary referral can cost as much $150 – not including any duplicative tests that might occur.
“It more easily permits consultation with and education from the specialist,” said Sajid Ahmed, L.A. Care’s director of health IT and innovations.
Along with the deployment of the portal, about 350 digital cameras have been sent to L.A. Care providers in order for them to take photos of their patient’s condition and send them on to the relevant specialist.
At the same time, the portal will also help speed up specialty referrals for L.A. Care enrollees who need such a visit, according to Ahmed.
The eConsult portal launched earlier this week with connections to L.A. Care’s dermatologist and neurologist networks at seven different sites through the county. Both specialty panels receive a high number of patient referrals, according to Ahmed.
By the end of the year, eConsult is expected to be available to all L.A. Care specialists via 53 clinic sites – including all clinics operated by the Los Angeles County Department of Health Services. DHS is a partner in the project, along with the Community Clinic Association of Los Angeles County, the Health Care L.A. Independent Practice Association and MedPoint Management.
L.A. County DHS also offered all encounter data from 6 million patients it has treated at its facilities for insertion into the eConsult system, making it more easy for network physicians to pull up complete medical histories of their patients.
“eConsult enables our primary care providers and specialists to communicate directly and manage a patient’s non-urgent needs without a face-to-face visit, and can shorten the wait time if a specialist appointment is needed,” said Alexander Li, M.D., chief executive officer of the DHS’ ambulatory care network.
Safety Net Connect, a Newport Beach-based healthcare software firm, supplied the software for both the pilot project and the buildout. The cost of deployment was about $1.5 million, according to Ahmed.
At IEHP, about 5,000 enrollees with diabetes have entered into a vital sign monitoring telehealth project intended to better manage diseases such as diabetes.
IEHP enrollees will be able to use electronic devices to monitor and gather glucose levels, nutritional intake and other variables. The monitors can interface with electronic gateways installed at the offices of 600 providers in IEHP’s network and be uploaded into a Web portal.
“The caregiver can set ranges with alarms on it that will automatically notify (them) if the patient’s data is out of range and hopefully avoid an ER visit,” said Bret Morey, director of marketing for ForaCare, the Newbury Park-based firm that is providing the hardware and monitoring services to IEHP.
Various studies suggest that the cost of treating unmanaged diabetes is more than eight times higher than keeping it under control.
An IEHP spokesperson declined comment about the project, saying it was still in its initial stages and “we are working through processes.”
L.A. Care provides managed care to about 1 million Medi-Cal, SPD and Healthy Families enrollees in Los Angeles County. IEHP provides the same coverage to about 540,000 lives in Riverside and and San Bernardino Counties.
