With rapidly rising costs and increased demand for services, America’s healthcare system desperately needs solutions that drive down costs while improving patient health.
One such solution is the Equal Access to Specialty Care Everywhere (EASE) Act, legislation in Congress which would break down barriers to health care access, reduce costs and improve the quality of care by expanding telehealth opportunities.
Leveraging technology holds great potential for strengthening America’s health care infrastructure. The EASE Act can be a key step in such an effort by creating a virtual, specialty health care provider network for underserved patients who need specialized care.
Even when receiving initial treatment from their family physicians, some patients have chronic or life-threatening conditions – such as heart disease, diabetes, and obesity – that specialists with more training and advanced treatment options could address more effectively and efficiently. When patients with these conditions are unable to secure a timely appointment with a specialist, or face lengthy delays, their conditions often deteriorate. This results in increased numbers of visits to the emergency room, urgent care, or the family physician and causes higher out-of-pocket costs and worse quality of life.
These shortfalls all result in higher premiums and greater costs to federal and state health care programs – an increased burden carried by taxpayers.
Americans know the problem of lengthy wait times for specialty care far too well. For example, a study of a group of community health clinics in the OCHIN Network found that only 43% of patient specialty care referrals were successfully completed between October 2022 and September 2023. This means patients did not receive necessary follow-up care more than 57% of the time. Even when patients booked a referral appointment, they were forced to wait an average of 73 days for access to a gastroenterologist, 62 days for a cardiologist, and 54 days for a behavioral health specialist.
On top of that, an OCHIN analysis found that the average general wait time to see a specialist increased from 50 days in 2019 to 58 days in 2023. The problem is only getting worse.
By embracing vital telehealth tools, we can connect patients with convenient access to care before a health problem goes from bad to worse. The EASE Act would use existing Center for Medicare and Medicaid Innovation (CMMI) funds to test a virtual specialty network dedicated to providing increased telehealth opportunities, in partnership with primary care providers in underserved and rural communities.
Importantly, by using existing funds, this legislation would advance innovative new health care solutions without increased government spending.
Based on pilot projects involving virtual specialty care, OCHIN found that patients and health plans experienced significant cost savings, dramatic reductions in wait times, and a decrease in the number of referrals required for in-person care with a specialist.
The benefits of expanded telehealth are numerous. In addition to lower costs and better care, telehealth can be especially valuable for patients who cannot afford or are unable to drive long distances, a benefit also realized by caregivers who often bear the burden of lengthy travel to doctors’ visits.
The innovative approach to health care found in the EASE Act will improve the quality and coordination of care, lower costs, and strengthen health care access for patients across the board. Congress has an opportunity to embrace this innovative way to reach patients everywhere and improve outcomes across the board. We urge all policymakers in Congress to support this bipartisan, bicameral legislation to strengthen health care in America.
Congresswoman Michelle Steel is the U.S. Representative for California’s 45th District serving residents in Orange Counties. She is a member of the Ways and Means Committee, which has jurisdiction over proposals relating to taxation, insurance, and health care, and is the author of the EASE Act. Abby Sears is the president and CEO of OCHIN, a national nonprofit health care innovation network.
