Billing patients to email docs eased provider workloads
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Charging patients to message their doctors through portals could reduce health worker burnout and modestly lightened clinicians' workloads at the Mayo Clinic, researchers said.
Why it matters: More health systems have been charging to answer patient queries since the Centers for Medicare and Medicaid Services allowed providers to bill for virtual check-ins that involve decision-making and at least five minutes of clinicians' time.
- But the practice was found to discourage some patients from messaging, which could widen health inequities.
Catch up quick: The volume of messages sent through online patient portals increased 157% during the height of the COVID-19 pandemic, and high message volumes have largely persisted.
- Providers say they add significant unpaid work to their already packed schedules and contribute to health worker burnout. The co-payments range from as little as $3 to $30 to $100, per the New York Times.
What they found: The volume of patient messages seeking medical advice decreased 8.8% in the six months after the Mayo Clinic implemented a billing system for some online check-ins, a new study in the Annals of Internal Medicine found.
- There was no difference in emergency department visits or hospitalizations between patients who sent messages versus those who didn't after seeing the billing disclaimer on the patient portal.
Context: Mayo Clinic began billing for messaging in August 2023.
- A pop-up screen advised patients that they might be charged if they sent a message.
- Messages from an existing patient with new or multiple concerns requiring more than five minutes of the providers' time were eligible for billing. Providers could not bill for follow-up messages sent within seven days of an in-person or telehealth visit.
- Providers had to initiate the billing process for the message themselves. Patients faced a maximum out-of-pocket cost of $50 for each message thread.
Only three-tenths of a percent of the more than 1.65 million medical advice messages received throughout Mayo Clinic during the study period were actually billed, researchers said.
- Primary care providers used the billing option more than specialty providers.
Yes, but: Most providers at Mayo (66%) didn't perceive billing for messages as having a significant effect on their workloads.
- And while about 80% of providers agreed with billing for patient messages, some said having to decide whether or not to bill for an exchange actually added to their work.
