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Can Telemedicine Boost Medi-Cal Access?

Shirley Svorny

For years, Medi-Cal patients’ access to doctors has been limited, especially
for those who need specialty care or live in rural areas.

California’s low physician reimbursement rates are partly to
blame. The 2017-18 state budget includes a 2.5 percent increase in
reimbursements — the first increase since 2001 and totally dependent on new tobacco tax
revenues
.

There are other options worth considering. Interstate
telemedicine would allow an expansion of Medi-Cal services at
current reimbursement rates.

If California doctors
won’t take Medi-Cal patients, why not let out-of-state physicians
provide services?

If California doctors won’t take Medi-Cal patients, why not let
out-of-state physicians provide services? Rents and salaries are
lower in some states, which is why call centers are in the
Midwest.

California could allow physicians licensed in other states to
enroll as Medi-Cal providers to offer telemedicine services without
obtaining a California license, which is expensive and time
consuming.

Why would state legislators block out-of-state physicians?
According to the physicians’ lobby, the goal of licensing
regulations is not to protect them from competition but to ensure high-quality care.

But state medical boards don’t protect patients from low-quality
care and are notoriously bad at disciplining doctors.
Instead, quality assurance comes from efforts by health care
providers to protect their reputations and to avoid liability.

The U.S. Department of Veterans Affairs, whose problems
providing care have made national headlines, will soon allow its
physicians to practice telemedicine in any state. Why shouldn’t
California do the same for Medi-Cal patients?

The Legislature should end the requirement that out-of-state
physicians secure a California license to provide telemedicine care
to Medi-Cal patients. Not only would such as change expand options
for Medi-Cal recipients, it would let the state experiment with
interstate telemedicine, which has the potential to make health
care more accessible and less costly for all Californians.

Shirley
Svorny
is a professor of economics at California State
University, Northridge, and an adjunct scholar at the Cato
Institute.