Patient message billing cut provider workload, but not ED visits: Mayo Clinic

A Rochester, Minn.-based Mayo Clinic study found that charging for patient messages can reduce physician load without impacting patient volume.

E-visit bill was implemented at the system on Aug. 18, 2023. The study, published Dec. 31, 2025, in Annals of Internal Medicine, compared the volume of patient-initiated medical advice message threads pre- and postimplementation and the perceptions of providers answering messages. Here are four findings:

1. Six months after implementing billing, the volume of message threads decreased by 8.8% — going from 1,813,818 messages to 1,653,708. 

2. Of messages sent, 0.3%, or 5,183, were billed. 

3. There was no difference in the seven-day use of emergency services in patients who sent a message compared to those who did not send a message.

4. Providers overall said they found the new process acceptable.

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