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

[jprice3]

Thanks Art. 
Private payers may want to drift back to covering telehealth at a lower rate than in person visits. Your case argues that tele was of equal value to the payer in avoiding a more expensive UC or ED visit (and of greater value to the family, even though the payer may not care so much about that)

Sent from my iPad

> On Apr 24, 2021, at 10:32 AM, Arthur Lavin <alavinmd at gmail.com> wrote:
> 
> 
> 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
> 
> 
>> 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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