For Californians who are uninsured or on Medi-Cal, obtaining timely access to a gastroenterologist, dermatologist, or other specialist presents a major challenge. Relationships among specialists and primary care providers are often poorly defined, leading to fragmented care. CHCF explores strategies to improve access and more effective use of specialty care for the underserved.
January 2012
A collaboration between CHCF and Kaiser Permanente Community Benefit supports innovative regional and local solutions to improve specialty care access in the health care safety net.
April 2010
An issue brief reports on the impact, challenges, and lessons learned from a redesign project to expand specialty-care access for patients in a Los Angeles network of community clinics. A second report provides an independent evaluation of the project.
December 2009
Telepsychiatry is used in some emergency departments to make the process of evaluating and treating patients with mental health issues more efficient. This paper examines seven ED telepsychiatry programs in terms of structure, financing, and challenges.
December 2009
Dermatologists can serve many more patients — regardless of distance or scheduling — by using store-and-forward teledermatology systems. This CHCF paper looks at criteria for evaluating these systems, and gives a comparative overview of four available applications.
July 2009
To provide some specialty services onsite, Federally Qualified Health Centers (FQHCs) in California must comply with federal scope-of-project and reimbursement regulations. This paper explains the rules and provides practical guidelines for meeting them.
July 2009
This business planning guide offers tools for community clinics and clinic consortia that are considering participating in a shared specialty network. It provides hands-on tools such as worksheets, checklists, and examples.
July 2009
This research looks at programs for improving access and overcoming barriers to good specialty care for low-income populations. Case studies offer insights for enhancing specialty care access.
June 2009
To improve access and reduce wait times for specialty services, many specialty practices have incorporated physician assistants (PAs) and nurse practitioners (NPs) into their health care. This report highlights six models that have been financially sustainable.
May 2009
Californians who depend for their health care on safety-net institutions often have difficulty getting access to specialty care. This report examines the size and causes of the problem and looks at efforts to create solutions.
May 2009
Developing effective strategies for specialty care referrals in the safety net requires a clear understanding of the typical clinical scenarios that generate such referrals. This paper presents insights from interviews with community and public hospital clinics.
September 2008
This report describes eight software systems that allow health care providers to process patient referrals using web-based tools rather than the error-prone use of paper forms, telephone calls, and faxes. Four case studies are included.