Messaging costs

Digital patient engagement at risk?  

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   The pandemic saw an increase use of telemedicine and virtual consultation services. While patient engagement on portals have historically been a struggle, the use of portals for medical information and communication rose during the pandemic as healthcare moved from brick-and-motor to the home. The unforeseen side effects of patient messages were providers spending large amounts of time replying to inquiries.  

   In order to address this strain on the system, Cleveland Clinic became one of the first hospitals to begin billing for messages providers make around medical history reviews, assessments or decisions in care. UCSF Health is another early adopter of patient-provider messaging billing.  

   The costs to patients will vary. Those with private insurance can expect a co-pay of $20, $3 - $6 for those with traditional Medicare and up to $50 for those without coverage.  

   While charging for messages helps justify the load for clinicians, this billing practice is already proving to be a detriment to low-income patients who cannot afford these new medical costs. Researchers have discovered lower message volumes from UCSF patients after the new billing practices were implemented and surprisingly a 5x increase in televisits.  

   Researchers recommend monitoring costs and the effects of patient-provider messaging on outcomes.  

   The question becomes: Does patient-provider messaging billing encourage or restrict patient engagement in their care?  

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