Patients who seek help from their doctors through online portals may soon notice something new: the fees for their doctors’ online consultation.
A growing number of health care systems across the country are now charging for certain types of messages sent through online patient portals, such as MyChart, with fees often around $35 or less. It’s a trend that’s drawing mixed reactions, with some saying it feels right, while others see it as a cash grab.
In the Chicago area, NorthShore University HealthSystem began billing for certain types of messages sent through its patient portal, NorthShoreConnect, earlier this month. He joined Northwestern Medicine and Lurie Children’s Hospital in practice. Nationally, the Cleveland Clinic made headlines this month when it announced it would begin billing for some communications. UCSF Health in California also charges for some messages.
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Healthcare leaders say most messages remain free, and they only bill questions that take more than a few minutes of a doctor’s time and would, in the past, likely have merited an in-person visit.
“Some of these messages have become increasingly complex and are replacing what might have been a telephone consultation or an in-person consultation,” said Richard Gundling, vice president of the Healthcare Financial Management Association, a professional group of healthcare finance leaders. “None of us want to sit in waiting rooms anymore after the pandemic. We’re used to telehealth…now we access our providers differently. Health systems are responding in kind”.
Some consumer advocates, however, criticize the trend as greedy.
“This is once again big business in healthcare finding ways to profit from every angle on patients,” said Cynthia Fisher, founder and president of Patient Rights Advocate, a Massachusetts-based advocacy group that has followed the trend.
He fears that some people will now hesitate to ask their doctors questions, out of fear they could be charged. “It really disproportionately disproportionately disadvantages and hurts the very people who can afford it least,” she said.
NorthShore announced in an email to patients last month that most messages will remain free, but patients may be charged for some requests and questions, such as those about new symptoms, medication adjustments, new prescriptions, flare-ups of chronic and other conditions that take a long time to review a patient’s medical history.
The costs will be invoiced to the patient insurance. In NorthShore, direct costs for people with Medicare will range from about $3 to $10, while patients with private insurance and Medicare Advantage can have similar co-pays as for in-person and video visits, Colette said. , NorthShore spokesperson. Urban. The cost will be $35 for paying patients without insurance.
Patients must first agree to billing before doctors will answer questions.
“The COVID-19 pandemic has led to more patients seeking virtual health care options such as video and phone visits,” Urban said in a statement. “In addition to online visits, messaging a provider through a secure patient portal offers consumers another way to receive quality, affordable and accessible care. … While most online messaging is free, there may be times when a doctor’s response to a patient requires more complex medical decision-making and discussion.
Northwestern and Lurie, which already billed some messages, say very few of their MyChart messages incur charges.
During a three-month period earlier this year, Northwestern charged less than 1% for messages on its MyChart portal. Northwestern charges $35 per meeting, spokesman Christopher King said.
Similarly, Lurie has billed for about 300 MyChart meetings over the past year, a sliver of the nearly 300,000 messages he’s received, Dr. Ravi Patel, vice president of digital health for Lurie.
“The intent here is not to charge for MyChart messages,” Patel said, noting that patients are not charged for quick questions, such as those about scheduling an appointment, following up after an in-person appointment, or needing of a refill of medicines.
“It’s really for those instances where you have a new problem, a new symptom, a recurring symptom that’s come up again, a new rash,” she said.
It’s just another way for patients to access care, he said.
“Ten years ago, you did it in person, that’s all,” Patel said, adding that Lurie now does video visits as well. “The beauty is, 10 years later, we’ve tripled the ways you can get care and hopefully see patients outside the hospital.”
The trick for healthcare systems may be to strike a balance between making sure doctors are compensated for their time, without overburdening patients with messages that don’t require a lot of work or expertise, said John Hargraves, director of data strategy for the Health Care Cost Institute, a non-profit organization that studies trends in health care costs.
But expect the trend to grow.
“I don’t think there’s any way to go back and make it a service that no one is paying for,” he said. “Most things with health care and costs only move in one direction. When something is known to be billable, it is rarely not billed.”