Practice Notes

Access expansion in practice: Turning a profit on e-consults

Anita Joseph

Nine million adults contact a physician through e-medicine annually, and demand for "virtual visits" is growing as patients seek greater convenience. But e-consults are seldom reimbursed, if at all. So what can a medical group do?

Sentara Medical Group has eased the reimbursement challenge by partnering with MDLIVE, a virtual health care provider that offers video consultations to patients. Patients pay a flat fee for each consultation, and physicians receive a portion of that payment.

How it works

The sequence is fairly simple:

  • First, patients put in an online consultation request.
  • MDLIVE then calls out to physicians, seeking one who is immediately available.
  • If the physician doesn’t call back within 15 minutes, MDLIVE moves on to the next provider.

On average, patients see a physician within 22 minutes.

Sentara physicians currently have the option to accept e-consults when they have space on their schedule. The virtual visits are not intended to replace traditional ones and are only included in the calculation of physicians’ productivity if income is guaranteed.

This arrangement allows them to maintain their traditional revenue stream while generating as much additional revenue through e-consults as they can accommodate.

Strong potential for expansion

Over time, Sentara expects to expand its use of the service. The medical group’s parent system, Sentara Healthcare, is already offering a discount on MDLIVE use for its self-insured employees, recognizing that e-consults cost less than traditional visits. Although MDLIVE is currently used exclusively in primary care, the medical group is also considering how they might be used for pre-op or follow-up visits in specialty care.

Any such expansion may require the group to re-consider whether e-consults should be treated more like traditional visits in compensating physicians. In the meantime, however, the pilot has allowed Sentara to expose its physicians to the e-consult workflow while mitigating payment concerns.

Learn More

For further information on trends in medical group strategy, from physician employment to compensation models and performance data, check out our recent posts in Practice Notes.


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