The nation's three largest pharmacy chains have announced plans to close nearly 1,500 underperforming stores.
It wasn't long ago that the expansion into primary care by the nation's leading retail pharmacy chains was seen as a threat to traditional providers.
However, a spate of financial woes, leadership shuffles, staff shortages and related store closings at CVS Health, Walgreens Boot Alliance, and the recent bankruptcy filing by Rite Aid have prompted the chains to pull back on their primary care initiatives.
Combined, the nation's three largest pharmacy chains have announced plans to close nearly 1,500 underperforming stores.
The problems facing the three retail pharmacies are similar, and include rising drug prices, pressure from insurers, post-pandemic changes in customer behavior that have reduced store traffic, and an alarming spike in shoplifting.
In February, traditional primary care providers were warned about the incursions by these nontraditional providers. An American Hospital Association-commissioned report placed Walgreens and CVS among a handful of big retailers and payers, including Amazon, Walmart, and UnitedHealth Group, that were identified as major disruptors in the primary care sector.
"The nation's largest retail, payer and tech disruptors once again invested billions of dollars in healthcare in 2022, continuing to build out their visions to transform the field," the report said.
CVS had planned a major expansion in the primary care market in 2024 following its $10.6 billion acquisition in May of Oak Street Health, the value-based, primary care platform.
Walgreens had a similar strategy with the creation of Walgreens Health and a $5 billion majority stake in VillageMD, acquired in October 2022, an acquisition that then-CEO Roz Brewer called “a new strategy to transform our core businesses.”
"Our strategy leverages an ecosystem including our trusted brands, exceptional assets, healthcare expertise and scale, integrated with a range of new talent, capabilities, resources and an intensified focus on operational excellence to drive long-term sustainable profit growth," Brewer said.
However, those aspirations have not panned out for CVS, Walgreens or Rite Aid, as all of them have reported ongoing financial underperformance this year.
Walgreens
Last week, Walgreens, rocked by financial woes, a leadership shakeup, the wobbly launch of a value-based care initiative, and pharmacists in open revolt, named veteran healthcare executive Tim Wentworth as its new CEO, effective October 23.
Wentworth replaces Brewer, who left abruptly in early September after less than three years at the helm. Following her out the door were CFO James Kehoe and CIO Hsiao Wang.
During an Oct. 13 call with investors, Walgreens announced plans to close 60 VillageMD clinics and exit five markets in 2024 to cut at least $1 billion in costs as it pivots its strategy with Wentworth.
Two days after naming Wentworth CEO, the drugstore chain released its Q4 earnings report, showing a net loss of $3.1 billion for the year, compared to net earnings of $4.3 billion for the 2022.
"Our performance this year has not reflected WBA's strong assets, brand legacy, or our commitment to our customers and patients,” Walgreens interim CEO Ginger Graham said at the time.
“In just six weeks, we have taken a number of steps to align our cost structure with our business performance, including planned cost reductions of at least $1 billion, and lowered capital expenditures by approximately $600 million.”
CVS
The C-suite shuffle at CVS Health continued this week with the announcement that CFO and President of Health Services Shawn Guertin is taking a leave of absence “due to unforeseen family health reasons.”
In his stead, Tom Cowhey, SVP of Corporate Finance, has been named interim CFO, and Mike Pykosz, CEO of Oak Street Health, has been named interim President of Health Services, the Woonsocket, RI-based company announced.
“Our thoughts are with Shawn and his family during this difficult period,” CVS Health President / CEO Karen S. Lynch said. “The Board and I have every confidence that Tom and Mike will ensure we continue to execute our strategy seamlessly while we give Shawn time to be with his family.”
However temporary, the executive shuffle at CVS comes two weeks before the company will report its Q3 findings on Nov. 1.
In August CVS announced a restructuring plan that will eliminate 5,000 jobs to save $600 million, as it released a disappointing Q2 earnings report which showed a net income of $1.9 billion, a 37% decline year-over-year.
During the August investors call, Lynch said CVS wants to trim up to $800 million in expenses in 2024 while shifting resources to expand Oak Street Health.
"These actions enable us to reallocate resources and invest in critical growth areas, such as health services and technology, which are the biggest enabler of our strategy," Lynch said on a call. "We've taken meaningful steps executing on our long-term strategy with tangible proof of the value of our unique integrated offering."
Guertin was appointed president of Health Services on Sept. 7 as part of a reorganization that expanded the roles of several senior executives.
That September reorganization also saw Chief Pharmacy Officer Prem Shah named president of Pharmacy and Consumer Wellness; Chief Customer and Experience Officer Michelle Peluso charged with enhancing patients' end-to-end experience across the company's service channels; and Brian Kane taking over as president of Aetna, a move that was announced in April.
Rite Aid
Also this week, Rite Aid, hobbled by $4 billion in debts, filed for bankruptcy on Sunday with plans to close hundreds of underperforming stores and sell Elixir, its pharmacy benefits subsidiary.
Court documents show that Rite Aid lost $1 billion in the months ahead of its bankruptcy filing, and the chain warned investors that it may not be able to keep the business operational.
Rite Aid paid $2 billion for Elixir in 2015, but analysts believe the company won't recoup even half that much in the sale.
“Rite Aid's bankruptcy filing follows years of underperformance compared with its drug retail peers, yielding a weakened competitive position, elevated financial leverage and limited cash flow generation,” FitchRatings said this week.
Of more than 2.3 million primary care visits, 51% used telemedicine (19.5% video and 31.3% telephone).
In-person follow-up visits were a bit higher after telemedicine consultations when compared with in-person primary care visits, but that varied by specific clinical condition, according to a study published today in Annals of Internal Medicine.
The study, compiled by clinicians at Kaiser Permanente in Oakland, CA, and funded primarily by a grant from the Agency for Healthcare Research and Quality, sought to discern how well telemedicine addresses patient needs post-COVID public health emergency.
The study examined a large, integrated health care delivery system with more than 1,300 primary care providers, between April 2021 and December 2021 (including the COVID-19 pandemic Delta wave). Researchers examined the electronic health records of more than 1.5 million adult patients, of whom 26% age 65 or older, 55% were woman, 22% were Asian, 7.4% were Black, 22% were Hispanic, 46.5% were White, 21.5% lived in less-affluent neighborhoods, and 31.8% had a chronic health condition.
Of more than 2.3 million primary care visits, 51% used telemedicine (19.5% video and 31.3% telephone). Medications were prescribed in 47% of office visits, 38% of video visits, and 34.6% of telephone visits.
After the visit, 1.3% of in-person visits, 6.2% of video visits, and 7.6% of telephone visits had a 7-day return in-person primary care visit; 1.6% of in-person visits, 1.8% of video visits, and 2.1% of telephone visits were followed by an emergency department visit. Differences in follow-up office visits were largest after index office versus telephone visits for acute pain conditions and smallest for mental health.
Treatments administered included medication or antibiotic prescribing and laboratory or imaging ordering. Follow-up visits included in-person visits to the primary care office or emergency department or hospitalization within 7 days.
Outcomes were adjusted for sociodemographic and clinical characteristics overall and stratified by clinical area (abdominal pain, gastrointestinal concerns, back pain, dermatologic concerns, musculoskeletal pain, routine care, hypertension or diabetes, and mental health).
In the study setting, telemedicine is fully integrated with ongoing EHRs and with clinicians, and the study examines an insured population during the late COVID-19 pandemic period. Observational comparison lacks detailed severity or symptom measures. Follow-up was limited to 7 days. Clinical area categorization uses diagnosis code rather than symptom.
Tim Wentworth, the founding CEO of Evernorth, will face daunting challenges from Day One at the retail chain.
Walgreens Boots Alliance, Inc., rocked by financial woes, a leadership shakeup, the wobbly launch of a value-based care initiative, and pharmacists in open revolt, has named veteran healthcare executive Tim Wentworth as its new CEO, effective on October 23.
The announcement comes on the eve of Walgreens Q4 earnings report. Analysts are predicting that the company will end the fiscal year with earnings of about $34 billion, down 7.3% year-over-year. Walgreens has seen its stock value halved in the past year, reaching a 12-year low in mid-July.
The company’s cost-cutting measures, announced in early July, include layoffs for about 10% of its workforce and closing 150 stores nationwide and another 300 stores in the United Kingdom by August 2024.
Walgreens’ recent financial woes may have prompted the surprise departure of CEO Rosalind Brewer in early September, who left abruptly after only two years at the helm. Following her out the door were CFO James Kehoe and CIO Hsiao Wang.
In addition to the financial woes, Walgreens is staring at an open revolt among pharmacists and technicians, who this week walked off the job at several stores to protest chronic understaffing, long hours, and a volatile work environment. The walkout brought with it a boatload of bad publicity for Walgreens and forced the chain to temporarily close several stores.
Rocky Launch of Value-based Care
In October 2021, Walgreens unveiled Walgreens Health, which it described as a "new consumer-centric healthcare strategy to drive sustainable, long-term profitable growth." The venture partnered with VillageMD and CareCentrix -- where WBA owns a majority stake -- to "accelerating the company's capabilities in primary care, post-acute care and home care." However, the rollout has been rocky and unprofitable for Walgreens, and also played a role in Brewer's departure.
In mid-September, Walgreens announced a partnership with clinical technology provider Pearl Health that they said would accelerate the drug retailer's expansion into value-based care.
Veteran Leader
Wentworth says he sees his new post as an "incredible opportunity to lead the next phase of WBA's evolution, working with the Board and WBA leadership to deliver sustainable value and results.”
"WBA has a differentiated model with the power to build on the company’s pharmacy strength and trusted brand to evolve healthcare delivery, Wentworth said in a media release. "I believe in WBA’s vision to be the leading partner in reimagining local healthcare and well-being for all.”
Wentworth's blue-chip resume in the healthcare sector includes his most-recent role as founding CEO of Cigna subsidiary Evernorth.
Before that, he was CEO of Express Scripts, the largest pharmacy benefit manager in the United States, following the company's merger with Medco Health Solutions, Inc. in 2012, where he grew the company into a Fortune 22 company with more than $100 billion in revenue and 26,000 employees. He has also served in leadership roles at Accredo, Medco’s specialty pharmacy, and Mary Kay, Inc.
"I’ve spent my career working to improve the health of the patients we've served. I believe WBA is well-positioned to deliver more personalized, coordinated care, and achieve better outcomes at a lower cost,” Wentworth said.
"I fully recognize the challenges that health plans, healthcare providers, pharmacies, and retailers are confronting today and am confident that WBA, and its customer- and patient-focused teams, can seize the opportunities of a dynamic marketplace and be the partner of choice.”
The hospital lobby and the chairman of the HELP committee provide vastly different analyses on the extent of charity care and community benefits provided by nonprofits.
Sen. Bernie Sanders, I-VT, and the American Hospital Association are at odds over the level of community benefits and charity care that nonprofit hospitals provide in exchange for their tax-exempt status.
Sanders, chairman of the Senate Committee on Health, Education, Labor and Pensions (HELP) released a report this week that claims that nonprofit hospitals aren't holding up their end of the bargain.
"Hospitals have gladly accepted the tax benefits that come with nonprofit status but have failed to provide the required community benefits," Sanders says in his report. "Non-profit hospitals spent only an estimated $16 billion on charity care in 2020, or about 57% of the value of their tax breaks in the same year. Those hospitals have made information about their charity care programs difficult to access, leaving many patients unaware that they may qualify for free ordiscounted care."
The AHA this week fired back with a report showing that nonprofit hospitals provided more than $129 billion in community benefits in 2020.
"Even in the face of a once-in-a-century pandemic, all hospitals, regardless of ownership type, continued to provide a comprehensive range of benefits, programs and essential services to their communities," AHA says. "The analysis calculates that tax-exempt hospitals' and health systems' total community benefits were 15.5% of their total expenses in 2020, based on data from the Internal Revenue."
Pharmacy workers at Walgreens are walking off the job as labor unrest continues to rock the healthcare sector.
If you're tracking recent labor unrest in the United States these days, be forewarned that it could trigger a bout of vertigo.
Sometimes it seems like the whole country is on strike, with major walkouts seen in the auto industry, entertainment, and of course, healthcare.
Healthcare workers' grievances are pretty much the same: overworked, understaffed, underpaid.
The recently completed three-day walkout by more than 75,000 Kaiser Permanente workers—reportedly the largest healthcare sector strike in U.S. history—is technically over, but the issues that prompted the walkout, essentially staffing and compensation, have not been resolved.
The Coalition of Kaiser Permanente Unions this week gave the mega-healthcare system a three-week deadline to negotiate a settlement or risk a weeklong walkout starting on Nov. 1.
And, you might want to call your local Walgreens before you schlep over there for your meds. They might not be open. That's because frazzled, overworked pharmacy staff at some of the retailer's stores in several states walked out on Monday after complaining of harsh working conditions. The walkout is expected to last through Wednesday.
To its credit, Walgreens has acknowledged the stressors on its pharmacy workers and the sacrifices they've made.
"Our pharmacy teams work tirelessly to serve our communities—from administering life-saving vaccines, to helping patients receive prescriptions and health screenings—especially this time of year, during which we see some of the highest rates of respiratory illnesses and seasonal vaccinations," the company says today in prepared remarks to HealthLeaders.
"The last few years have required an unprecedented effort from our team members, and we share their pride in this work—while recognizing it has been a very challenging time. We also understand the immense pressures felt across the U.S. in retail pharmacy right now."
"We are engaged and listening to the concerns raised by some of our team members. We are committed to ensuring that our entire pharmacy team has the support and resources necessary to continue to provide the best care to our patients while taking care of their own well-being. We are making significant investments in pharmacist wages and hiring bonuses to attract/retain talent," the company says.
The Walgreens labor unrest comes on the heels of similar unrest at rival CVS Health, where late last month pharmacists in the Kansas City area—complaining of chronic understaffing and demanding overtime pay—walked off the job, prompting the closure of two dozen stores in the region.
"It's like running a McDonald's with just one person," one pharmacist told The Kansas City Star.
Another CVS pharmacist told The Star that CVS relies on an " 'arbitrary algorithm' to determine how many technician hours each pharmacy deserves per week."
Like Walgreens, CVS appears to have conceded its errors. In an internal memo to employees CVS Chief Pharmacy Officer Prem Shah apologized and admitted that "we haven't addressed these concerns in the region more quickly."
"With the currently unprecedented demand for vaccinations from our patients in mind, we are taking a series of actions effective immediately," Shah told employees. He says the company has pledged to provide "additional resources" to stores, hiring more workers, and easing the workload on pharmacists.
CVS issued a statement saying "we're committed to providing access to consistent, safe, high-quality health care to the patients and communities we serve and are working with our pharmacists to directly address any concerns they may have."
"We're focused on developing a sustainable, scalable action plan to support both our pharmacists and our customers, that can be put in place in markets where support may be needed so we can continue delivering the high-quality care our patients depend on," the company says.
The CVS pharmacists' action garnered the support of the American Pharmacists Association (APhA), which noted that "pharmacists who find themselves in situations where the welfare of others is in question should always pause, evaluate the situation, and take the steps necessary to ensure safe, optimal patient care."
APhA also warned that the overworked, understaffed, underpaid conditions pharmacy workers endure are also a common complaint across the healthcare sector.
"The issues that lead to suboptimal healthcare working environments are complex and are not unique to pharmacies," APhA says. "We see similar situations in physicians' offices, hospitals, and other practice settings. Our health care system needs change which leads to supporting the patient–provider (including the pharmacist provider) relationship."
The California Pharmacists Association was blunt, blaming CVS for a "massive prescription backlogs of its own making, in large part due to aggressive patient-steering tactics driven by its Pharmacy Benefit Manager company, CVS Caremark."
"Due to these practices, patients are increasingly being denied access to other community and independent pharmacies where their pharmacy needs could be met," CPhA says. "This cherry-picking of patients away from other pharmacies, coupled with persistent understaffing at its own pharmacies, along with unreasonable workloads, has caused the untenable situation that its pharmacists and patients face today."
What makes the pharmacists' walkout from the nation's two biggest drug chains particularly notable is that these pharmacy workers are not unionized. It would be safe to say that the typical pharmacist is hardly a labor radical, so this grassroots and desperate action on their own is as remarkable as it is difficult to coordinate.
But when nonunion workers feel compelled to conduct an organized protest, that's a signal that the dissatisfaction runs deep and wide and should not be ignored.
September's 41,000 new healthcare jobs were 22% below the average 53,000 jobs the sector created over the past 12 months.
Healthcare added 41,000 jobs in September and represented more than 12% of the 336,000 jobs created in the overall economy for the month, according to the Bureau of Labor Statistics.
While the healthcare sector continues to be a powerhouse job creator, September's 41,000 new healthcare jobs were 22% below the average 53,000 jobs the sector created over the past 12 months, BLS says.
More than half (24,000) of the new jobs were created in ambulatory services, while hospitals and the residential and nursing care sector each accounted for 8,000 new jobs, BLS says.
September's 336,000 new jobs are 25% higher than the average monthly gain of 267,000 jobs over the past 12 months.
Despite the robust job growth in the overall economy, the unemployment rate remains unchanged at 3.8%, with 6.4 million people reporting as unemployed, unchanged from August. Big job gains were seen in leisure and hospitality (96,000), government (73,000), social assistance (25,000) and professional and technical services (29,000).
In September, average hourly earnings for all employees on private nonfarm payrolls rose by 7 cents, or 0.2%, to $33.88. Over the past 12 months, average hourly earnings have increased by 4.2%. The average hourly earnings of private-sector production and nonsupervisory employees rose by 6 cents, or 0.2%, to $29.06.
The September statistics published by BLS are preliminary and subject to revision. Revised July and August employment numbers recorded 119,000 new jobs.
Nationally, telehealth diagnoses continued to be led by mental health conditions, which held at nearly 69% of telehealth claims.
Telehealth use slipped 5.6% across the nation in July, falling from to 5.1% of all private insurance and Medicare Advantage claims, down from 5.4% of those claims in June, according to nonprofit FAIR Health’s monthly tracker.
The South saw the nation’s biggest decline in telehealth use, falling by 9.3% from June to July, according to the tracker, which does not include Medicaid and fee-for-service Medicare.
In July, FAIR tracked the cost of CPT®3 99443 (telephone medical discussion with physician, 21-30 minutes.) and found that the median charge nationally for a telehealth visit was $211.49, and the median allowed amount was $97.93.
Nationally, telehealth diagnoses continued to be led by mental health conditions, which flickered around 69% of telehealth claims. That trend was similar in every region of the country, although the Northeast saw a more pronounced drop from 76.6% of telehealth claims in June to 75.9% in July, while the South and West recorded slight increases.
Other top telehealth claims were filed for developmental disorders, joint/soft tissue diseases, and endocrine and metabolic disorders.
Other highlights:
In the Midwest in July, sleep disorders climbed from fifth to third place in the rankings of telehealth diagnoses (from 1.2% of claim lines in June to 1.3% in July).
Nationally, the percentage of asynchronous telehealth claim for hypertension increased from 13.2% in June to 14% in July. The percentage of claim lines in all areas for the number one asynchronous diagnosis—mental health conditions—remained relatively stable in July.
Increases in asynchronous telehealth claim lines for hypertension occurred in every region except the Northeast, where they decreased from 23.3% in June to 22.6% in July.
Hypertension ranked number one for asynchronous telehealth claims the Midwest, climbing from the number two ranking in June (18.7% of claim lines), to number one in July (26.5%).
Hypertension displaced mental health conditions in the Midwest, which dropped from first place with 36% of claim lines in June to second place with 20.6% in July.
Audio-only telehealth held steady nationally in urban areas (4.8%) and increased slightly in rural areas 4.6% in July.
Nationally and in the South, urban areas showed higher telehealth use than rural areas, while in the Midwest, West and Northeast, use was higher in rural areas than urban areas.
The collaboration could expand to 'the entire drug discovery continuum', the two companies say.
Novo Nordisk and Boston-based Valo Health, Inc. this week announced the launch of a collaboration that taps Valo's artificial intelligence-powered platform to develop new drugs treating cardiometabolic diseases.
Using a $60 million upfront and near-term milestone payment, the collaborative could generate as much as $2.7 billion for Valo across 11 programs, along with R&D funding, and potential royalty payments.
Novo Nordisk already licenses three preclinical drug discovery programs in cardiovascular diseases discovered and developed by Valo using its AI-powered Opal Computational Platform. The platform provides access to real-world patient data, AI-enabled small molecule discovery, and a human tissue modelling platform that accelerates development.
"Artificial Intelligence and machine learning hold the promise to positively impact drug discovery and development, in particular enabling our vision of leveraging human datasets early in the process, which should lead to a better understanding of target biology," says Marcus Schindler, chief scientific officer of Novo Nordisk.
"Valo brings a differentiated and powerful approach to using these technologies on real-world human data to generate new insights and translate them into potential therapeutics for the benefit of patients suffering from cardiometabolic conditions," he says.
The collaboration could expand to "the entire drug discovery continuum", the two companies say, with Novo Nordisk and Valo partnering to tap human genetic and longitudinal patient data in cardiovascular disease.
"Partnering with Novo Nordisk… creates a unique opportunity to continue to deploy our Opal Computational Platform at scale in the discovery and development of novel cardiometabolic therapeutics," says Valo CEO / Founder David Berry.
"We are excited to implement the full spectrum of our platform spanning from disease characterization through clinical development as we aim to deliver new therapeutics to benefit patients living with some of the most prevalent chronic diseases of our time."
The wholesale club's discount offering is designed for uninsured members and those with high-deductible plans.
Wholesaler Costco is partnering with primary care telehealth "superstore" Sesame to offer $29 virtual visits for uninsured club members and those with high-deductible plans, the two companies announced Monday.
The discounted virtual care provided by Sesame's primary care physicians and nurse practitioners will be available to Costco members across 50 states. The partnership will also offer in-person health check-ups with standard lab panels and virtual follow-up consultations for $72, and virtual mental health sessions for $79, and a 10% discount for in-person visits.
Sesame does not accept health insurance.
Describing itself as "America's only superstore for great doctors and specialists," New York City-based Sesame says it has created "a unique healthcare marketplace, connecting thousands of outpatient healthcare providers covering all 50 United States with American consumers seeking high quality, convenient medical care at half the price of what is typical."
"By bringing marketplace dynamics to consumer healthcare for the first time, Sesame has created an environment where providers actually compete to serve patients, regardless of the patient's insurance status," Sesame says. "The resulting competition lowers the price of care, drives complete price transparency, provides ready access to health providers, mostly within two hours."
The Sesame partnership is the latest foray into healthcare by Issaquah, WA-based Costco. In 2011, Costco partnered with Aetna to create a health insurance plan for its members. That partnership transition in 2022 to Custom Benefit Consultants and expanded to provide members and member businesses with a health insurance marketplace, often with discounted prices.
In 2021, Walmart, Inc. entered the telehealth space with the acquisition of MeMed, allowing the retail giant to offer tele-behavioral and primary care across the nation. Amazon also stepped up its telehealth game in February with its $3.9 billion acquisition of San Francisco-based One Medical. The deal gives Amazon access to One Medical's virtual care platform, and more than 200 brick-and-mortar care venues, which operate in about 26 markets, and includes over 800,000 members.
However, Costco and Sesame claim their partnership is unique because it "provides its members access to Sesame's marketplace of low-price healthcare services, virtually or in-person with a provider, all at an exclusive discount."
"With the option to bring healthcare into their home, Costco members will have access to care in a setting that's right for them and have the option to develop long-term doctor-patient relationships with a Sesame provider."
Physicians will review every response before they're sent to patients to ensure the 'human touch.'
Ochsner Health this month is launching a pilot program that uses artificial intelligence to send "simple messages" to patients through its MyOchsner app portal.
Under the program the AI drafts responses to routine patient queries, which will be reviewed and edited by physicians before they're forwarded to patients. The hope is that the AI will accelerate physician responses to patient queries while also reducing the time that physicians are spending each day in front of a screen responding to reams of email messages from patients, and allowing them more face time with patients.
The first phase of the pilot will include about 100 Ochsner clinicians across the sprawling health system's 46 hospitals and hundreds of care venues that will use Microsoft's Azure OpenAI Service linked with Epic's electronic health record software, testing simple messages unrelated to diagnoses or clinical judgments.
"Ochsner has long been a leader in using digital tools to improve the patient experience," Ochsner CMIO Louis Jeansonne, MD says. "Now we are looking at how technology can simplify workflows for our clinical staff, which should significantly reduce the hours they are spending away from patients."
In a media release describing the pilot, Ochsner clinicians stressed that no AI generated responses would be sent to patients without being reviewed by their providers to ensure
a "human touch." The tech is incorporated into clinical workflows with HIPAA-compliant encryption for privacy.
"The AI will generate a draft for the clinician to review and send. It's meant to help clinicians respond more quickly to patient messages, so patients can get answers to their questions sooner," Ochsner Chief Application Officer Amy Trainor says. "And it will reduce time our clinicians are spending on computers so that they can spend more time doing what they do best—direct patient care."
Once seen as a niche or novel component of care delivery, EHR messaging expanded rapidly during the coronavirus pandemic and it has grown to become a virtually ubiquitous tool for most providers. However, a growing number of physicians have complained that they're overwhelmed by email responses, often spending several hours each day to complete them.
A study in the Annals of Family Medicine found that primary care physicians were spending more than half of their workday, nearly 6 out of 12 hours, addressing EHR messages. More than four million medical advice requests were sent to physicians via the MyOchsner app in 2022.
Some health systems are confronting the growing use of electronic messaging by charging patients a small copay. Cleveland Clinic, for example, charges three billing rates for virtual queries based on the amount of time a physician needs to complete the task.
To facilitate the process, the Centers for Medicare & Medicaid Services in 2020 created three billing codes for e-visits.
