Payors to reimburse for physician online visits

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Two large health insurance companies are helping physicians move out of the doctor’s office to virtual house calls.

Aetna and Cigna have agreed to reimburse doctors for online visits and other large insurers are expected to follow, according to the Los Angeles Times (LAT).

The virtual visits, which typically cost the same as a regular office visit, are aimed primarily at those who already have a doctor and are considered best for follow-up consultations and treatment for minor ailments, such as colds and sore throats.

Some specialists, however, including cardiologists and gynecologists, also see the e-mail sessions as ideal for periodic checkups that do not require in-person visits.

"People can wait a long time to get in to see their primary-care doctor and longer for a specialist. . . . To have immediate access is huge," said Melissa Welch, MD, Aetna's Northern California medical director.

LAT reported that as more doctors move online, others are looking further ahead and adding webcams to their online arsenal, evidence that long-delayed efforts to bring American medicine into the digital age may be gaining momentum, experts say.

"Paying doctors to do more patient care over the internet is a small but important step in a good direction," said David Cutler, a Harvard University healthcare economist. "It increases patient access and could significantly improve their satisfaction."

If so, it comes at a time when doctor visits in the United States have surged 20 percent in the last five years to more than 1.2 billion visits annually, according to the Centers for Disease Control and Prevention. As the population ages, the number of doctors is falling across the country, and experts predict that office wait times will increase in the coming years, reported LAT.

At the same time, at-home devices that monitor blood pressure and diabetics' sugar levels remotely are becoming less expensive. Companies like Google and Microsoft are expected to introduce products this year to simplify patient care and put medical records online, although neither company plans to assist in online physician appointments, according to LAT.

Critics, including many doctors, contend that online medical care carries risks. Some worry that mistakes are bound to happen and that the practice raises several hard-to-answer ethical questions.

"It's perfectly appropriate that we use 21st century technology in the 21st century," California Medical Association President Richard S. Frankenstein, MD, an Orange County pulmonologist told LAT. "The concern I have is that [online visits] are simply not a substitute for an actual doctor."