Containing Cost while Maintaining Quality

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Containing Costs While Maintaining Quality

Managed Care Matters

from Drug Benefit Trends^®
Posted 02/03/2003

http://www.medscape.com/viewarticle/447793

Some Physicians to Be Paid for Online Consults

Blue Shield of California plans to begin paying HMO- and PPO-contracted physicians for providing online consultations beginning in the first quarter of 2003. At press time, the plan had not decided how much physicians would be paid.

The decision follows release of a study conducted by a Stanford University researcher and funded by Blue Shield of California, San Francisco, and ConnectiCare Inc, an HMO based in Farmington, Conn. ConnectiCare is not paying physicians for online consultations at this time.

In the study, physicians were paid $20 per online consultation involving minor, nonurgent matters. Using a secure messaging system developed by RelayHealth Corp, Emeryville, Calif, physicians and patients were able to communicate about refills, laboratory results, appointments, and referrals.

Health care spending for office visits by the treatment group averaged $1.87 less per member per month (PMPM) compared with spending for office visits by the control group. Study results indicated that Web visits cost insurers $0.33 PMPM, a net savings of $1.54 PMPM. If savings are extrapolated for the 2 million members of Blue Shield of California, the insurer could potentially save more than $3 million a month.

Of the physicians who participated in the project, 63% said they were likely to continue using the RelayHealth service and 56% said they preferred to handle patients' nonurgent health care needs via the Internet versus at the office.

The study involving members of Blue Shield of California and ConnectiCare was conducted by Laurence Baker, PhD, assistant professor, department of health research and policy, at Stanford University. Baker analyzed and compared the health care spending patterns of 2274 patients in the treatment group who had access to the RelayHealth Service with those of 3390 patients in a control group. Claims for the 2 groups were reviewed for the 12-month period before the RelayHealth service became available and for an 11-month period ending February 28, 2002, during which the service was available.

Participating physicians interviewed in the November 25 issue of AMNews reported a high degree of satisfaction in being able to offer online consults, saying that the online system allows them to be paid for advice previously dispensed over the phone at no charge. It also saves time for physicians and their staffs by shifting requests for referrals, refills, laboratory results, and appointments from the phone to the Web. An online system provides better documentation of what was said and when as well.

Ninety percent of adults who use e-mail would like to be able to communicate with their physicians online in order to ask questions when no visit is necessary (77%), make appointments (71%), refill prescriptions (71%), and receive results of medical tests (70%). The more affluent persons are, the more likely they would be willing to pay for this service. As for how much patients would be willing to pay, the average response was just over $10 a month as a fixed amount, or nearly $7 each time they sent an e-mail.