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The state of telehealth in Medi-Cal managed care: taking stock in the era of COVID-19
The state of telehealth in Medi-Cal managed care: taking stock in the era of COVID-19
- Collection:
- Health Policy and Services Research
- Contributor(s):
- BluePath Health, issuing body.
California HealthCare Foundation, issuing body. - Publication:
- [Oakland, California] : California Health Care Foundation, April 2020
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Managed Care Programs
Medicaid
Telemedicine
California
United States - Genre(s):
- Technical Report
- Abstract:
- Never have the benefits and importance of expanding access to telehealth been more evident than they are now, in the midst of a global pandemic from COVID-19, given the evidence that human-to-human contact is considered to be the primary mode of transmission. Even in normal times, telehealth increases access to care by expanding options for patients to connect with providers and by significantly decreasing wait times between a referral and a subsequent visit. Its potential to help patients get the care they need when they need it is particularly great in Medi-Cal, California's Medicaid program. Twenty-five percent of Medi-Cal enrollees report difficulty finding a specialist when they need one--a rate over two times greater than for Californians with employer-based coverage. In 2019, the California Department of Health Care Services (DHCS), which administers Medi-Cal, expanded coverage for telehealth. Among many changes, DHCS lifted restrictions on which services could be provided through telehealth (clinicians now have the authority to determine clinical appropriateness) and established billing codes and payment rates for specialists providing electronic consultations. In 2020, in response to the pandemic, state officials swiftly took additional action to expand access to telehealth, including allowing Federally Qualified Health Centers and other Medi-Cal providers to bill for phone visits and other visits that originate outside a clinical setting. Whether these changes are temporary or take root is unknown at this time. For the more than 10 million Medi-Cal enrollees in managed care, managed care plans (MCPs) are responsible for ensuring their members receive timely access to care. However, the extent to which Medi-Cal MCPs are using telehealth to improve access to care for their members has not been studied. This report provides a first look at the telehealth landscape among Medi-Cal MCPs, including a snapshot of use in 2019 and insight into the priorities, approaches, and challenges of MCPs in offering telehealth services to their members. The findings reflect surveys completed by 17 of the 24 Medi-Cal MCPs, representing 88% of Medi-Cal managed care enrollees and all three plan types: County Organized Health Systems, local initiative health plans, and commercial plans.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
- Extent:
- 1 online resource (1 PDF file (21 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101771848 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101771848