Each year approximately 14,000 children are born in North Carolina who have or will develop special health care needs. The supply of sub-specialists needed to support these children's local primary care providers is limited and concentrated in the six major medical centers across the state. To encourage and facilitate consultation between primary care providers (PCP) and these physician sub-specialists (PS), a program for paying for distant "electronic" consults was initiated in 2006 with support from the North Carolina Foundation for Advanced Health Programs, Inc.
The program was piloted in the Infectious Disease clinics at most facilities (GI at NC Children's Hospital). PS were paid to provide distant consult services. To receive compensation, they provided minimal data identifying the patient, the PCP requesting the consult and the presenting problem in need of PS input (see attached Reimbursement Request Form). They also checked a CPT code describing the method of electronic response (email or phone with 3 codes distinguishing between lengths of phone consults). Finally, the PS described whether the consult resulted in the avoidance of a specialist visit, ER visit, hospitalization, transfer to another hospital or some other type of service specified by the physician. Analyses of the resulting data showed that each dollar spent resulted in ~ $39 saved through voidance of additional medical services. A paper describing the success of the program will be published in Pediatrics shortly. A set of PowerPoint slides describing the program and its results is available here.
by Steven Wegner, Charles Humble, John Feaganes and Alan Stiles
Pediatrics
2008; 122, e1136-e1140
DOI: 10.1542/peds.2008-0432
Contact Charles Humble or Courtney Sanderson.
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