[Ohioaap-practicemanagers] Keeping Telehealth Parity--help needed

[Arthur Lavin]

Thanks for this Jon,

What an urgently important need!

I would first put forward a fiscal argument.   Take as a given that a
pediatrician will need to meet with a child and/or their family to deliver
necessary medical care.
Now the only question that remains, will that medical service be delivered
by televisit or in person?  Either way, service will be delivered, and
needs to be compensated.  There is currently no controversy about paying
for covered service in person.   My value proposition to all insurance
payors is that the doctor is going to be paid by you for an agreed covered
service in person, what is lost in agreeing to do so via video?   I can see
a concern raised that if telehealth remains covered, utilization will
soar.  But the pandemic has proven that will not happen.  Across primary
care, even with the gates flung wide open to virtual care, utilization
dropped, even during a time of tremendous health worry.  So let's cover
telehealth, it does not cost more, it meets the current reality that this
is how we communicate.

For concrete examples, I can present the case of a child who has a very
worrisome rash, that came on suddenly, at day care, and the mother had
limited means of transportation.  The question was very simple, should the
child be brought to an emergency room or not?  How urgent was the
situation?  Now, if the rash indicated a deadly disease, moments mattered.
 But rather than simply send all such situation immediately to a very
expensive ER, the option of telehealth allowed a very prompt evaluation to
be given.  I saw the rash, it was a heat rash, presented no health hazards,
and so the family was reassured, their day not disrupted, very expensive
care at an ER averted, and I got paid for my medical services.  Why
wouldn't our insurer colleagues not want to continue coverage of such a
service?  Such examples have abounded in my practice since telehealth was
covered.

Arthur
Arthur Lavin, MD, Fellow of the AAP
3733 Park East Drive, Suite 102, Beachwood, OH 44122
P 216.591.1515 |F 216.591.1544
www.AdvancedPed.com <http://www.advancedped.com/>


On Fri, Apr 23, 2021 at 1:20 PM Jon Price via Ohioaap-practicemanagers <
ohioaap-practicemanagers at lists.deltaforce.net> wrote:

> The Chapter wants your best reasons to keep telehealth payment parity for
> children. Commercial insurance is under no obligation to keep parity for as
> long as Medicaid will. Give me any examples that might include engaging
> patients you weren’t able to reach via in person visits, increased
> difficulty in executing a good telehealth visit for the average child vs
> average adult, etc. I’ll advance them when the Ohio Pediatric Care Council
> next meets with payers, sooner if necessary.
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