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Teledermatology improves access to care among Medicaid enrollees

Patients enrolled in Medicaid appeared to have improved access to dermatology care through teledermatology, with a higher percentage of newly enrolled patients receiving teledermatology care, according to study results recently published in JAMA Dermatology.

Researchers analyzed claims data from Health Plan of San Joaquin, a large California Medicaid managed care plan that began offering teledermatology as a covered service in April 2012. There were 382,801 patients from California’s Central Valley enrolled, including 108,480 newly enrolled patients who received coverage following the implementation of the Affordable Care Act.

The researchers compared rates for dermatology visits by patients with primary care practices that referred patients to teledermatology with those that did not.

Data were collected between April 1, 2012, and Dec, 31, 2014, and analyzed between March 1 and Oct. 15, 2015.

Of the patients enrolled for at least 1 day during the study period, there 8,614 (2.2%) with one or more visits with a dermatologist, and48.5% of those patients received care via teledermatology. There were 80.2% store-and-forward visits and 19.8% in-person follow-up visits with teledermatologists.

There were 75.7% of patients newly enrolled in Medicaid who visited a dermatologist who received care via teledermatology. 

There was a 63.8% increase in the fraction of patients who visited a dermatologist among primary care practices that engaged in teledermatology compared with a 20.5% in other practices (P < .01).

“Compared with in-person dermatology, teledermatology served more patients younger vs. older than 17 years (58.7% vs. 33.5%), male patients (41.8% vs. 36.4%), nonwhite patients (66.4% vs. 53%), and individuals without comorbid conditions (72.8% vs. 65.4%; P <.001 for all comparisons),” the researchers wrote.

Viral skin lesions and acne were more like to be cared for by teledermatology physicians, while patients with psoriasis and skin neoplasm were more likely to be treated by in-person dermatologists.

“This particular model, and teledermatology in general, offer promise for other Medicaid plans that struggle with meeting the specialty care needs of traditional as well as new enrollees,” the researchers concluded. – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.