e-visit

Trend: Physician online consult volume growing

Anne Zieger — Sun, 27 Jul 2008 19:13:11 -0400

As we've reported for more than a year, online physician consults via the internet (sometimes known as "e-visits") are growing more popular over time. While some physicians are leery of conducting patient check-ins online, as they're concerned they'll miss a critical detail, others believe that such visits are fine for patients with minor ailments. In any event, about one-third of e-consults end with the doctor asking the patient to come in for a face-to-face visit, according to e-visit technology vendor RelayHealth.

Insurers like Aetna and Cigna have come on board and begun reimbursing for such visits, making it more tempting for doctors to consider such an approach.

Right now, the number of physicians who are offering such services is small, but it's grown decisively since some major insurers began reimbursing for e-visits. For example, the number of Cigna physicians offering online consults has grown 33 percent this year, though it still only accounts for 12,000 of its 500,000 doctors. Meanwhile, about 5 percent of Aetna's 490,000 doctors have signed up for e-visit services.

Smaller insurers have seen an increase in e-visits, too. For example, Blue Cross Blue Shield of Florida began offering online physician visits to patients back in 2004, and today, a few thousand of its 28,000 doctors use this technology. These doctors generate only a dozen e-consults per month for the entire group, but BCBS executives note that doctors may be using the system largely for its free features at present.

To learn more about this trend:
- read this South Florida Sun-Sentinel article

Related Articles:
Insurers keep getting on web visit bandwagon
Health plans begin reimbursing for 'virtual visits'
Study: MD e-mails could drain physician income
Physicians offer 'e-care'

Medicare may allow payment for virtual consults

Anne Zieger — Sat, 05 Jul 2008 14:44:32 -0400

CMS has proposed new regulations that, as of 2009, would allow physicians to bill Medicare for follow-up inpatient consultations, along with adding 56 new measures to the Physician Quality Reporting Initiative. CMS projects that under the new rule, it would pay $54 billion to 980,000 physicians and other providers next year. If the rules are approved, they would represent a major moment in the progress of "e-visits," few of which are reimbursed by insurers to date.

Under the proposed rule, CMS would add new codes to its list, designating consultations done electronically with a patient's attending physician when the consulting doctor wasn't available for an in-person discussion. To make sure hospitals don't worry about using the codes, the rule would give hospitals a safe harbor from self-referral limits. The exception falls under rules allowing payments from hospitals to medical staff members under programs rewarding quality care, such as value-based purchasing programs.

Since CMS hasn't provided any technical standards for such visits, it seems likely that if the rule is approved, it will trigger a wave of technical experimentation around how to support such visits. After all, while providers like Duke have put portals in place to support some forms of physician-patient communication, it's still rare for hospitals to have infrastructure in place to support any form of telemedical consult. I expect to see a big scramble among IT departments if CMS moves ahead.

To learn more about the proposal:
- read this Modern Healthcare article (reg. req.)

Related Articles:
Insurers keep getting on web visit bandwagon
Health plans begin reimbursing for 'virtual visits'
Physicians offer 'e-care'

Insurers keep getting on web visit bandwagon

Mon, 07 Apr 2008 06:59:55 -0400

A growing number of health plans have begun to pay for patients to participate in online visits with their doctor. In recent months Aetna and Cigna have started paying for some doctors' visits on the web, and given their industry status as being influential, others are sure to follow soon. In both cases, patients have to pay a co-pay to have an e-visit, just as they would if they saw the doctor in person. Meanwhile, players like McKesson-owned Relay Health is slowly but surely gathering subscribers for its secure web site tailored to delivering e-visits, signing up 16,000 physician subscribers to date. Aetna and Cigna both contract with Relay Health.

All that being said, one major player remains on the sidelines to date. Things will get really interesting when Medicare pays for online visits. However, there's currently no word as to how soon that might happen, if at all, though it is experimenting with other telemedicine options.

To learn more about this trend:
- read this Philadelphia Inquirer piece

Related Articles:
Health plans begin reimbursing for 'virtual visits.' Report
Study: MD e-mails could drain physician income. Report
Physicians offer 'e-care.' Report