Telehealth and the Safety Net: An Analysis of Cost and Care

Safety-net providers face an unprecedented demand for services from the Affordable Care Act (ACA), related Medi-Cal expansion, and the existing large number of uninsured people in California. While growing evidence shows that telehealth can be an effective tool for improving health care quality and outcomes while reducing costs, safety-net providers still struggle with how to best incorporate telehealth-delivered care into their operations.

With grant funding from the Blue Shield of California Foundation (BSCF), CCHP examined the true costs of safety-net clinics providing telehealth-delivered services. Clinic costs and savings will help answer key questions around how telehealth can help safety-net providers meet health care reform challenges, and inform future reimbursement rate negotiations with managed care plans.

The California Telehealth Resource Center (CTRC) worked with five selected California safety-net health centers to optimize their telehealth program.  Milliman, Inc., a nationally recognized actuarial firm, worked closely with the participants, as well as major payer plans, to complete the cost analysis.

THIS PROJECT CAME TO A CLOSE IN JULY 2015:  

As a result of this project, CCHP has released two reports which examined the cost and reimbursement barriers faced by community health centers (CHC) when using telehealth to serve their clients.  Looking at financial and billing records of five California federally qualified health centers (FQHCs) and rural health centers (RHCs) with a history of employing telehealth, the reports examine whether these telehealth programs can be self-sustaining under current reimbursement policies, and how best to quantify these costs in the design of alternative payment models.  These reports provide a framework for charting the future of community health centers for using available connected health technologies to increase access and quality for the underserved.

The two reports are as follows:

• Community Health Centers and Telehealth: A Cost Analysis Report & Recommendations, summarizes the project findings and includes a series of policy recommendations and suggestions for advancing the use of telehealth among CHCs.
• California Community Health Centers: Financial Analysis of Telehealth Programs, summarizes the in-depth fiscal analysis conducted by Milliman, Inc. of each of the five CHCs that participated in this study.

In October 2015, CCHP conducted a webinar that explored the barriers and potential solutions for California Community Health Centers (CHCs) in employing telehealth services. Presenters shared the findings and recommendations of this study and discussed the potential for using telehealth with alternative payment models. Watch the webinar.