Cleveland Clinic bills for less than 1% of weekly MyChart messages

Cleveland Clinic began billing patients for electronic messages through Epic's MyChart patient portal in November. Since then, it has charged fees for responses to less than 1 percent of the 110,000 weekly emails its providers received, The New York Times reported Jan. 24.

Five things to know:

1. Cleveland Clinic said its email volume doubled since 2019 due to the expansion of telemedicine and electronic health communications and relaxed billing rules during the pandemic. 

2. Cleveland Clinic said Medicaid patients are not charged and Medicare beneficiaries without a supplemental health plan would owe between $3 and $8, according to the report. The system's maximum charge, affecting those with high deductibles on private insurance plans or without coverage, would be $33 to $50 for each exchange.

3. Federal rules dictate that a billable message must be in response to a patient inquiry and take at least five minutes. Commercial payers have followed CMS' lead, reimbursing healthcare practices for physicians' emails, and may charge patients a copay. The move has opened up a new revenue stream for health systems, but some providers have raised concerns about the effects these charges could have on health equity and access to care.

4. MyChart messages declined at UCSF Health in San Francisco after the system began billing for them, though providers rarely charge patients for them, according to a JAMA study. After allowing clinicians to decide when to bill for messages, in November 2021, patient message threads and overall messages dropped slightly at UCSF Health. Providers only charged for about 2 percent of message threads, but researchers argued future studies should examine overall costs under different payment models and the effects of messaging billing on health outcomes, equity, and patient and provider experience.

5. Becker's has reported on several health systems that now charge patients for electronic messages through patient portals like MyChart, including Houston Methodist, Chicago-based Northwestern Medicine, Lehigh Valley Health Network in Allentown, Pa., and Renton, Wash.-based Providence.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars