Insurers Pay for Web-Based Physician Visits
Health insurers Aetna and Cigna have announced that they will pay for online physician visits, and patients will be required to contribute a copayment for the visits, the Philadelphia Inquirer reports. Aetna on Jan. 1 expanded a pilot project in California, Florida and Washington state to the rest of the country, and Cigna said it would begin paying for online visits in January 2009. The insurers believe that members will like the service because it can improve efficiency and could prevent more costly problems, the Inquirer reports.
Aetna and Cigna contract with RelayHealth, a company that offers physician subscribers a secure Web site for administrative duties. Patients complete questionnaires about their symptoms. RelayHealth has a list of 150 illnesses, including acne and sinus pain, that are considered appropriate for "e-visits." Cigna members will contribute their usual copays, and physicians will be paid $25 for a Web visit, compared with $65 for an office visit. Aetna pays physicians $25 to $35 for a Web visit, compared with about $35 to $100 for an office visit. Aetna members contribute the same copay for either type of visit, and high-deductible plan members pay the whole fee.
"The payments are another sign of how information technology is changing the doctor-patient relationship while creating new quandaries," such as concerns about the privacy of patient information and whether physicians who use e-visits lose a personal aspect of providing care, according to the Inquirer. In addition, some physicians "wonder how patients will react to charges for a service that had been free," the Inquirer reports.
Jonah Frohlich, senior program officer for the California HealthCare Foundation, said the use of e-visits is "pretty much in its infancy, although I think it's going to rise." The foundation last year conducted a survey that found 4% of patients had e-mailed their physicians. Edward Fotsch, CEO of Medem, which provides 70,000 physicians with online services, said, "The actual utilization of e-consults is just incredibly low," adding that e-visits account for fewer than 5% of the transactions on Medem Web sites. He said the main reason physicians purchase his service "is to make their practice more efficient." However, Cigna spokesperson Joe Mondy said, "This is something that is taking off and has the potential to grow exponentially over the next few years" (Burling, Philadelphia Inquirer, 3/30).
