Wednesday, March 2, 2005
Physicians get paid for online consultations
Filed under: Telemedicine
The NYT reports that unlike telephone work, there's a trend starting for online consultations by physicians to be paid for by insurance companies, and physicians are interested since it's more efficient, increases patient satisfaction, and did we mention, WE GET PAID:
Since last year, several health plans - Anthem Blue Cross, Cigna and Harvard Pilgrim - have been paying Dartmouth-Hitchcock $30 for each online "visit," Dr. Walters said. In some health plans, a co-payment by the patient reduces the insurer's share. The medical center gives participating doctors credits - an e-mail consultation is valued at half an office visit - that increases their pay...Blue Cross and Blue Shield plans in California, New York, Florida, Massachusetts, New Hampshire, Colorado and Tennessee are beginning to pay doctors similar amounts ($24 to $30, including any co-payment) for online consultations. Blue Cross of California has made the program available to 160,000 of its 6 million health plan members. Last month, Empire Blue Cross and Blue Shield began testing the payment system with New York doctors at the Columbia University and Weill Cornell Medical Centers.
Kaiser Permanente, the nation's largest nonprofit managed care company, has tested patient-physician messaging in the Pacific Northwest and is starting the program this year in Hawaii and Colorado as part of Kaiser's $3 billion information technology program. Kaiser's salaried doctors get credits for messaging, adding to their pay.
System providers say overuse by doctors and fraud have not been problems. RelayHealth, a secure electronic system used by the Blue Cross and Blue Shield plans, for example, provides monthly user reports with names of doctors and patients...
Some employers are embracing medical e-mailing as a way to help maintain workers' productivity. "Why do I have to leave my office to check out my sore throat?" asked Dr. Jeff Rideout, corporate medical director of Cisco Systems, the big Silicon Valley technology company.
Cisco is paying the Palo Alto Medical Foundation [PAMF] for a one-year trial with the first 500 employees to sign up to see if providing online answers to medical questions eliminates unnecessary appointments for employees. The company's health costs have been rising at 10 percent a year, eroding overall productivity gains, Dr. Rideout said.
Sixty-nine of the foundation's 300 primary care doctors are online in a system provided by Epic. Dr. Paul Tang, the Palo Alto group's chief medical information officer, said it charged $60 a year for patients using the service.
Dr. Tang said most users were people with chronic diseases who were willing to pay for better access to their doctors. But other medical groups said they would prefer that insurers pay for e-mail consultations so there would be no barriers for patients...
Disclosure: the author is a partner at PAMF, uses Epic to provide online consultations, is a friend of Dr. Tang, used to work with folks at RelayHealth, and disputes the numbers quoted in the NYT article [more docs at PAMF do it]. How's that for journalistic freedom and fact checking?
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