I think this simply creates more pressure on the patient to try to take advantage of managing chronic disease by e-mail or telephone. And of course we don't charge (or get paid) for e-mail or telephone.
IT IS IMPERATIVE that we get the upper hand on e-visits, and keep them as a CASH option for our patients, NOT reimbursed by insurance. It is a real camels nose under the tent. Once we have some (and of course California and I think Massachusetts have already got a couple of insurance plans paying)plans paying, they all will, and when they all do, they will "negotiate" lower and lower rates.
This is especially important as I under a study will soon be out that claims 80% of primary care interactions can safely be handled as an e-visit. With the profoundly lower overhead of these visits we MUST make use of these.
