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Patient Portal Use is Growing, But Physician Billing in Medicare Hasn’t Caught Up

April 10, 2024
Managed Healthcare Executive
Summary
**Patient Portal Use is Growing, But Physician Billing in Medicare Hasn’t Caught Up** A study reveals an increase in Medicare beneficiaries using patient portals for communication with physicians, yet only a small fraction (~0.05%) of these communications result in a bill for Medicare, primarily for high blood pressure or diabetes management. Despite CMS's Medicare compensation for virtual services necessitating medical decision-making over five minutes during the COVID-19 pandemic, billed e-visits have plateaued since an initial surge. The study, headed by the University of Michigan, suggests providers might be wary of billing for portal messages due to concerns over patient costs, highlighting a need for clearer guidance on billing for digital patient interactions. **More than a Third of Americans Have Skipped a Healthcare Visit Due to Inability to Pay** According to a Payzen report surveying over a thousand Americans who had a hospital visit or surgery in the last two years, over a third of insured Americans and 83% of uninsured individuals have forgone healthcare visits due to cost concerns. The average American can only afford up to $97 a month out-of-pocket for healthcare expenses, with significant disparities across racial groups. The most commonly skipped services include preventative visits, prescription refills, mental health care, and diagnostic testing, underscoring the pressing issue of healthcare affordability in the United States.
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