West OC Times

With rapidly rising costs and increased demand for services, America’s healthcare system urgently 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 aimed at breaking down barriers to healthcare access, reducing costs, and improving the quality of care by expanding telehealth opportunities.

Leveraging technology holds significant potential for strengthening America’s healthcare infrastructure. The EASE Act can be a key step in this effort by creating a virtual specialty healthcare 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 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 result in higher premiums and greater costs to federal and state healthcare 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.

Additionally, 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 worsening.

By embracing vital telehealth tools, we can connect patients with convenient access to care before a health problem escalates. 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 healthcare 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 fewer 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 found in the EASE Act will improve the quality and coordination of care, lower costs, and strengthen healthcare access across the board. Congress has an opportunity to embrace this innovative way to reach patients everywhere and improve outcomes universally. We urge all policymakers in Congress to support this bipartisan legislation to strengthen healthcare 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 healthcare; she is also the author of the EASE Act.

Abby Sears is the president and CEO of OCHIN, a national nonprofit healthcare innovation network.