How MyChart fees could affect medically vulnerable patients

As hospitals and health systems look for ways to compensate their physicians for the after work hours spent answering MyChart messages, many have been implementing fees for some messages, but some say this could dissuade patients with chronic diseases from messaging providers, The Sacramento Bee reported Sept. 13. 

Cleveland Clinic, Rochester, Minn.-based Mayo Clinic, San Francisco-based UCSF Health, Nashville-based Vanderbilt Health, St. Louis-based BJC HealthCare and Chicago-based Northwestern Medicine are among the health systems that have begun charging for MyChart messages that require more than five minutes of a provider's time to answer.

And although only a small percentage of messages incur charges, healthcare professionals have raised concerns that these fees could affect medically and socially vulnerable patients. 

Caitlin Donovan, senior director at the National Patient Advocate Foundation, said even small copays can discourage patients from emailing their clinicians for medical advice in appropriate situations. 

Jay Holmgren, PhD, an assistant professor of health informatics at University of California San Francisco, also said the fees could dissuade those with serious chronic conditions from messaging their physicians. 

"We don't know who is negatively affected," he told the Bee. "Are we discouraging high-value messages that produce a lot of health gains? That is a serious concern."

So far, nine hospitals and health systems have begun implementing fees for MyChart in 2023.

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