Electronic consultation (eConsult) is an innovative solution that allows specialists and primary care providers to communicate electronically, improving access to specialist care. Understanding the cost implications of different remuneration models available to pay specialists is of critical importance as adoption of these services continues to increase. We used data collected through the Champlain BASE (Building Access to Specialists through eConsultation) eConsult service to simulate the cost implications of different remuneration models in Canada. The prorated hourly rate model averaged 45.72CAD(CanadianDollar)pereConsultwhiletheproratedhourlyratewithincentiveaveraged51.90 CAD per eConsult, and the fee for service cost 60.50CADpereConsult.PayingallspecialtygroupstoblockthreehoursperweekforeConsultsaveraged337.44 CAD per eConsult and paying for 1-h blocks averaged $133.41 CAD per eConsult. As the remuneration of specialists is the largest cost driver of an established eConsult service, our findings can inform policymakers considering the implementation of eConsult or wishing to further develop an existing service
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