Enjoy E-mail Paydays for Consultations

Physician's Money Digest, April30 2003, Volume 10, Issue 8

Physicians seeking a shortcut to e-mailsetup and compliance can take advantageof services like Online Consultation,Medem's Web-based service that allowsphysicians to communicate securely onlinewith patients. It also allows physiciansto receive payment for e-mail correspondencethrough a credit card system.

Payment for e-mail correspondence isan evolving issue. Some doctors tellpatients they might charge for the serviceand then charge based on the level ofcare. For instance, setting up an appointmentvia e-mail would be free, butextended consultations may be billed.Exactly who picks up the tab—insurancecarrier or patient—is also an evolvingissue. The Harris Poll showed that nearly40% of patients are willing to pay fore-mail's timesaving convenience.

PILOT PROGRAM LAUNCH

Just this month, Blue Cross Blue Shieldof Mass (BCBSMA) announced a pilot programto reimburse physicians for onlineWeb visits. The pilot program will be conductedin conjunction with RelayHealth(866-735-2963; www.relayhealth.com),also a provider of secure Web-based, doctor–patient services. Its online platform,the RelayHealth WebVisit, guides patientsthrough an interview and sends a messageto the physician with an array ofreplies for the patient.

BCBSMA will be the state's first healthplan to reimburse physicians for Web-Visits. However, it is the third BCBS-affiliatedhealth plan to begin offering reimbursementto physicians. BCBSMA willpay the participating physicians for eachWebVisit and members will pay an officevisit copayment depending on their planand the nature of the WebVisit. BCBSMAexpects to launch the pilot program thissummer, involving at least 500 physicians.

BCBSMA's announcement comes afterthe results of a large-scale study conductedby researchers at Stanford Universityand the University of California, Berkeley.The study evaluated the impact of Relay-Health's online communication service onsatisfaction among patients and physicians,and on the cost of care—includingcosts incurred by payors who reimbursedoctors for WebVisits.

INCREASED SATISFACTION

Not only did both patients and physiciansreport high levels of satisfaction anda shared preference for e-mail for nonurgentmatters, but the cost of care wassignificantly reduced. Patients in the RelayHealthtreatment group generatedcost savings in excess of $1 per patient permonth when compared to matched controlpatients. Both physicians and healthplans reportedly benefited. Physiciansreceived direct reimbursement for thecare provided in non–office-based encounters;reimbursing health plans saw agreater than 5-to-1 return on investment.

"In light of these strong results, BlueShield will work with RelayHealth toexpand reimbursement for doctor–patientWebVisits across both our PPO andHMO product lines," comments BruceBodaken, CEO of Blue Shield of Calif.

Dr. Eric Liederman, medical director forClinical Information Systems at the Universityof California Davis Health System,whose organization participated in thestudy and continues to communicate withpatients online, says, "A system has addedvalue when it allows doctors to get compensatedfor their time and expertisewhen providing medical advice to theirpatients online. Some doctors were skeptical,but now they would never go back."

"Doctor reimbursement for time spentonline with patients is critical to gainingtheir acceptance," says Giovanna Colella,MD, RelayHealth's president and CEO."The scientific evidence of economic benefitswill spur more payors to reimburse. Itimproves convenience while enhancingthe doctor–patient relationship."

For more information on e-mailissues, visit the Electronic Patient-CenteredCommunication Resource Center(www.e-pcc.org).