The bipartisan EASE Act introduces a virtual specialty care network to improve access for Medicare and Medicaid beneficiaries. Led by Representatives Michelle Steel and Susie Lee, the bill aims to leverage existing CMS funds to pilot virtual care modalities such as eConsults and telehealth. This initiative addresses the challenges faced by underserved populations in accessing specialty care, particularly in rural areas. Supported by OCHIN, a nonprofit research network, the legislation promises to enhance clinical capacity, patient access, and cost-effectiveness in healthcare delivery. Federal efforts, including CMS’s specialty care strategy, highlight the growing importance of innovative solutions in bridging the access gap. Research underscores the potential of virtual care to revolutionize specialty care delivery.
The Equal Access to Specialty Care Everywhere (EASE) Act, spearheaded by Representatives Michelle Steel and Susie Lee, addresses the critical need to expand access to specialty care for Medicare and Medicaid beneficiaries. Recognizing disparities in healthcare access, particularly in rural and underserved communities, the bill proposes the establishment of a virtual specialty care network. This network, funded through CMS innovation center resources, aims to harness the power of telehealth and eConsults to connect patients with specialized clinicians across various disciplines. The bipartisan support and endorsement from organizations like OCHIN underscore the urgency and importance of this initiative in improving healthcare equity and outcomes.
The proposed network would harness a range of virtual care technologies, including eConsults and telehealth, to link patients with healthcare professionals specializing in various fields such as cardiology, neurology, and endocrinology. It would operate in conjunction with patients’ primary care providers within local healthcare facilities, including federally qualified health centers, rural health clinics, and community health clinics.
Representative Steel emphasized the significance of telehealth in facilitating access to specialty care, particularly for rural and underserved communities. She highlighted the potential of telehealth to mitigate costly emergency room visits by enabling patients to address health concerns proactively, thus preventing them from escalating.
Backing the initiative, a diverse group of representatives including Andrea Salinas (D-OR), Mike Kelly (R-PA), Don Davis (D-NC), Darin LaHood (R-IL), Lori Chavez-DeRemer (R-OR), Don Bacon (R-NE), Yadira Caraveo (D-CO), and Monica De La Cruz (R-TX) have co-sponsored the bill. It has been referred to the Committee on Energy and Commerce and the Committee on Ways and Means for further consideration.
OCHIN, a nonprofit research and innovation network, has voiced support for the proposed legislation, emphasizing the importance of equitable access to specialty care for overall public health. Jennifer Stoll, Chief External Affairs Officer at OCHIN, commended the bipartisan efforts behind the EASE Act, recognizing its potential to bolster clinical capacity, enhance patient access, and mitigate healthcare costs for rural communities.
Studies have highlighted the challenges faced by certain populations in accessing specialty care. For instance, a 2019 study revealed that 60 percent of community health centers encountered difficulties in securing new patient specialty visits for their Medicaid beneficiaries, particularly in areas like orthopedics.
In response to such challenges, federal agencies have been actively seeking solutions to improve specialty care access. In 2021, the Centers for Medicare & Medicaid Services (CMS) outlined a goal to establish accountable care relationships for all original Medicare beneficiaries and the majority of Medicaid beneficiaries by 2030. To achieve this objective, CMMI developed a comprehensive specialty care strategy aimed at testing innovative models to support integrated specialty care delivery.
Released in 2022, the strategy includes initiatives to enhance data transparency regarding specialists’ performance and measures and to foster collaboration between primary care and specialty care providers.
Virtual care modalities have emerged as promising tools in bridging the specialty care access gap. Research indicates that these modalities can effectively cater to diverse specialty needs.
The EASE Act presents a significant step towards enhancing access to specialty care for Medicare and Medicaid populations. By leveraging virtual care modalities and existing CMS resources, the bill offers a promising solution to address disparities in healthcare access, particularly for underserved communities. The bipartisan support for this initiative reflects a shared commitment to improving healthcare equity and affordability. As federal agencies continue to prioritize innovative strategies to improve specialty care delivery, the EASE Act stands out as a comprehensive approach to bridge the access gap. Through collaboration and investment in virtual care solutions, we can ensure that all individuals, regardless of their location or socioeconomic status, receive timely and quality specialty care.
