Claims Management News

85% of People with Expensive Copays Prefer Email Communication

“Our findings show that patients perceive a significant value in being able to email their providers. As external settings work out their payment systems, they may be able to recoup some of that value as well.”

By Vera Gruessner

- One study stemming from Kaiser Permanente and published in The American Journal of Managed Care illustrated that one-third of patients who use email communication as their primary method of contacting their doctor reported better health. The researchers followed a total of 1,041 Kaiser Permanente patients with chronic conditions like asthma or congestive heart failure, according to a press release from the organization.

High Cost Sharing

An online patient portal was used to send secure email messages between patients and their primary care providers. The surveys were completed nearly five years ago by mail, phone, and online methods.

The most important findings from the health payer perspective include that 85 percent of patients who have higher cost sharing choose email communication as their initial method of contacting their physician, which is significantly higher than compared to the 65 percent of those with lower cost sharing who initially email. The researchers defined higher cost sharing as deductibles or co-pays of $60 or more.

This shows that consumers who have more to lose financially by visiting a doctor’s office would prefer to communicate with their physicians virtually – by email in this specific case. To learn more about how this study affects consumer spending habits and the health insurance industry, HealthPayerIntelligence.com spoke with Dr. Mary E. Reed, DrPH, Research Scientist with the Kaiser Permanente Division of Research.

HealthPayerIntelligence.com: How do your findings about physician-patient email communication affect the health payer industry?

Dr. Mary E. Reed: “Outside of the Kaiser Permanente setting, there’s quite a bit of consideration among payers about how to reimburse for and account for non-visit-based care. Integrated delivery systems such as Kaiser Permanente don’t have that same struggle, but rather can focus on offering comprehensive services to the patient.

“Our findings show that patients perceive a significant value in being able to email their providers. As external settings work out their payment systems, they may be able to recoup some of that value as well.”

HealthPayerIntelligence.com: Do you see doctor-patient emails improving public health or posing harm among those with high co-pays and deductibles?

Dr. Mary E. Reed: “We initiated this study wondering the exact same thing. We were curious how the copays and deductibles – the cost for in-person visits – might affect patient choice for email and then we were curious about patient-reported benefits and harm.

“What we found was that a large majority of patients do email their providers, and patients who had to pay more for their office visit reported using email as a first contact more often.

When we asked members who emailed their providers whether it improved or harmed their health, we found that about one-third said it improved their health in the last 12 months and two-thirds of them said that it didn’t change their health status. Exceedingly few – less than half of 1 percent – reported that their health was worse off because of emailing their provider.

“Based on the results, Kaiser Permanente is not too concerned about the potential for harm, since it does seem that in some patients there is a benefit.”

HealthPayerIntelligence.com: Do you think digital technology like telehealth and email communication will reduce the need for office visits and thereby lower medical costs across the industry?

Dr. Mary E. Reed: “I think there may be two things going on. First, patients may be able to replace some office visits with some sort of email communication with the provider. Also, we hear anecdotally that being able to email a provider may engage a patient in their care in a way that may lead to further needed care. So it’s not just a one-to-one substitution.

“We found that one-third of patients said their number of office visits decreased because of the emails they had with their providers, again about two-thirds said that there had been no change, and then 2.2 percent said that their office visits actually increased. We take that as a sign of some decreases in office visits and some increased efficiency, especially in patients with higher out-of-pocket costs.”

HealthPayerIntelligence.com: Are patients with chronic medical conditions the ones most likely to benefit from email as their main way to contact physicians?

Dr. Mary E. Reed: “With exactly that question in mind, we only looked at patients with chronic conditions because they have a fairly consistent need for health care, and we found that a substantial portion of patients with chronic conditions benefited from emailing their providers. In terms of comparing them to other patients, I wouldn’t assume that the impacts or benefits would be dramatically different in patients with fewer health care needs.

“If you are completely healthy, you might not email your provider at all, but not because it’s not potentially useful. Patients with chronic conditions have a reason to communicate with their provider by email, and we found that it does appear to affect their care-seeking patterns and health.”