A growing number of older Americans are relying on patient portals to communicate with their healthcare providers, but only a small share report being charged a copay for doing so, an April 4 study from the University of Michigan found.
The survey, published in JAMA Health Forum, was conducted in early 2024 through the National Poll on Healthy Aging. It examined portal messaging habits among U.S. adults 50 and older. Of the 3,200 respondents, more than three-quarters reported having access to a patient portal, and nearly two-thirds said they had used it to message a clinician within the past year.
Here are four findings from the study:
- Despite concerns that billing for portal messages could deter use — especially among those with lower incomes — just 13% of portal users said they were charged a copay.
- Privately insured patients were most likely to report a fee, with about 17% saying they were billed.
- Dual-eligible or Medicaid patients followed closely at nearly 16%.
- Those with Veterans Affairs coverage reported the highest portal usage but were among the least likely to face a copay.
Researchers noted the study’s limitations, including reliance on self-reported data and the inability to distinguish between billable and nonbillable messages. Still, they said the results warrant further exploration — particularly into how coverage differences may affect communication between low-income patients and their care teams.
