Some California physicians will be paid for online advice

Blue Shield of California's decision to pay doctors for answering patients' questions electronically means more insurers could follow suit.

By Tyler Chin, AMNews staff. Nov. 25, 2002.

At least one large health plan will reimburse physicians for online consultations after a Stanford University researcher reported that insurers could save more than $1 per member per month by doing so.

Blue Shield of California plans to begin paying HMO- and PPO-contracted doctors for online consultations in the first quarter of 2003, said Jeffrey Rideout, MD, president of the plan's CPS Foundation. Details remain to be worked out, including how much to pay, said Dr. Rideout, the health plan's former chief medical officer now in charge of its online consultation project.

Few insurers offer to reimburse physicians for online consultations, which include answering patient questions or treating them over the Internet. But the Stanford study, funded by San Francisco-based Blue Shield of California and ConnectiCare Inc., a Farmington, Conn.-based HMO, may give cost-conscious insurers a signal that paying for online consultations could yield greater savings down the line. The study is believed to be the first effort to measure return on investment to insurers from an online communication system.

"My guess is there will be significant movement in the next two years," said Michael J. Barrett, senior analyst at Forrester Research. "The heart of this is that the payer will conclude that it can pay less for an electronic visit than for an in-person office visit. For the payer this is a matter of getting the health care delivered via a cheaper medium."

The Blues plan and ConnectiCare helped test a secure messaging system from RelayHealth Corp., paying $20 per online consultation involving minor, nonurgent matters. Doctors and patients also used the Web-based system to communicate with each other regarding requests for refills, lab results, appointments, referrals and other transactions. The test involved 282 physicians and nearly 4,000 patients. [...]