San Francisco-based UCSF Health introduced billing for MyChart messages in November 2021, but did these fees actually reduce the volume of patient communications?
In response to a surge in message volume triggered by the COVID-19 pandemic in March 2020, several large health systems, including UCSF Health, began treating patient messages as billable e-visits. A study published in JAMA Aug. 9 associated this move with a slight decrease in overall message volume. However, the impact of these fees on different patient demographics remains less understood.
The JAMA study specifically analyzed how e-visit billing affected messaging rates at UCSF Health across various demographic groups. Researchers monitored weekly patient medical advice request messages from Oct.1, 2020, to Aug. 20, 2022, with Nov. 14, 2021, marking the start of billing. Over the 94-week study period, a total of 5,558,460 messages were tracked and researchers observed a 2% decline in the average number of weekly messages.
When examining the data by race and ethnicity, Latino patients experienced the most significant decline in average weekly messages following the implementation of e-visit billing.
Other most notable declines in average weekly message volume were observed among self-pay patients and those aged 18 to 49 years. Asian patients also experienced a somewhat greater reduction compared with other racial and ethnic groups.
Meanwhile, messaging volume increased for certain demographics, including patients over 65.