The Financial Implications of Digital Communication in Healthcare for Seniors

In a significant shift from traditional communication methods, many older adults have adapted to digital platforms, enabling them to message their healthcare providers securely through patient portals. This transformation, however, raises important questions about the costs associated with these interactions.

A recent study conducted by the University of Michigan Institute for Healthcare Policy and Innovation highlights that 76% of individuals aged 50 and above have at least one patient portal account. Among these users, 65% reported sending a message via the portal within the past year, with higher engagement noted among those with military or veterans' benefits, at 75%.

The study reveals that a concerning 13% of older adults who utilized the messaging feature encountered charges for these communications. Typically, healthcare providers are permitted to bill for such interactions if they involve five or more minutes of medical decision-making, a practice that aligns with telehealth regulations introduced during the COVID-19 pandemic and recently extended by Congress.

The data analyzed in this research stems from the National Poll on Healthy Aging, supported by AARP and Michigan Medicine. Conducted in late winter 2024, this poll builds upon previous findings regarding older adults' interaction with patient portals.

When examining billing discrepancies based on insurance types, the study found that 17% of older adults with private insurance faced charges for portal exchanges. This was similar for those covered by Medicaid, where 16% also reported receiving bills. In contrast, those with Medicare Advantage experienced lower rates of billing at 11.3%, with traditional Medicare holders facing even lower rates of 9.7%, and only 5.1% for those without supplemental coverage. Those covered by VA or military plans had the lowest incidence of billing at just 3.3%.

Lead researcher Terrence Liu, M.D., emphasizes the implications of these findings, particularly for financially vulnerable populations. He advocates for policies that ensure out-of-pocket costs do not deter these individuals from utilizing beneficial digital technologies.

Furthermore, Liu notes that state regulations often set lower co-payments for Medicaid recipients, which could be a model for improving affordability in digital communications.

This research aligns with previous studies indicating a digital divide among older adults, with those earning above $60,000 being significantly more likely to use digital health technologies compared to those with incomes below $30,000.

As patient portal messaging becomes increasingly prevalent, it is vital to ensure that the cost-sharing models reflect the value these services provide to patients. Awareness around potential costs prior to sending a message could aid in making informed decisions about using these platforms.

In summary, while the adoption of digital health communication offers numerous advantages for older adults, it is crucial to address the financial implications to ensure equitable access for all.