IMPORTANCE Access to specialists such as dermatologists is often limited for Medicaid enrollees. Teledermatology has been promoted as a potential solution; however, its effect on access to care at the population level has rarely been assessed. OBJECTIVES To evaluate the effect of teledermatology on the number of Medicaid enrollees who received dermatology care and to describe which patients were most likely to be referred to teledermatology. DESIGN, SETTING, AND PARTICIPANTS Claims data from a large California Medicaid managed care plan that began offering teledermatology as a covered service in April 2012 were analyzed. The plan enrolled 382 801 patients in California's Central Valley, including 108 480 newly enrolled patients who obtained coverage after the implementation of the Affordable Care Act. Rates of dermatology visits by patients affiliated with primary care practices that referred patients to teledermatology and those that did not were compared.

D irect-to-consumer (DTC) telemedicine offers patients immediate access to remote physicians via personal devices. These services were originally designed for patients seeking care for minor acute illnesses. In disasters, however, DTC telemedicine may facilitate care that would otherwise be inaccessible due to displacement, unpassable roads, emergency closures, or increased demand for healthcare services. 1 For the first time during the 2017 hurricane season, several DTC telemedicine companies including Doctor on Demand, MDLIVE, Teladoc, American Well, and LiveHealth Online offered free visits to hurricane victims. 2 To understand the role that DTC telemedicine may play in disaster response and recovery, we describe services provided by one DTC telemedicine company during Hurricanes Harvey and Irma.

No abstract

No abstract