[Ohioaap-practicemanagers] [ External ] - Re: Keeping Telehealth Parity--help needed

Sun Apr 25 14:14:11 EDT 2021

Group -

Here are a few thoughts from two of our providers.

Telehealth helped me in the following scenarios/Situations

  1.  Family of 5 children, Dad works numerous hours, mom does not drive and has multiple medical conditions. Had been very difficulty to have routine follow up visits for the children with ADHD, anxiety, asthma. Mom has been very responsive to telemed visits so I feel like I have still been able to care for the children when they otherwise would have been lost to followup.
  2.  Families with single parents working from home – in past would be difficult for that single parent to seek care with primary physician, would have over utilized ED services for acute illness that did not need ED. Families much more willing to schedule appt during the day as they were already working at home and found this easier than leaving work.
  3.  I have seen several children where in their home environment the child felt much more comfortable than they did in the office. This helped to really observe the child in their home environment to understand their circumstances.

Hope these examples help.

Lori Gordley, DO

Just had one today. Mom is sick but well enough to do a telehealth med fu for ADHD where we changed the medication dosage benefitting the child.

Have kept multiple kids out of urgent cares while OOT.

Petra Hackenberg-Bauer, MD

Theresa Von Hoene, CPEDC
Anderson Hills Pediatrics
Insurance Manager
513.232.8100 x3043

This e-mail, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity  to which it is addressed. If the reader of this e-mail is not the intended  recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution or copying of this e-mail is  prohibited. If you have received this e-mail in error, please notify the sender by replying to this message and delete this e-mail immediately.

________________________________
From: Ohioaap-practicemanagers <ohioaap-practicemanagers-bounces at lists.deltaforce.net> on behalf of jprice3 via Ohioaap-practicemanagers <ohioaap-practicemanagers at lists.deltaforce.net>
Sent: Saturday, April 24, 2021 11:45 AM
To: Arthur Lavin <alavinmd at gmail.com>
Cc: Ohio AAP Prctc Mngr Listserv <ohioaap-practicemanagers at lists.deltaforce.net>
Subject: [ External ] - Re: [Ohioaap-practicemanagers] Keeping Telehealth Parity--help needed

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
[http://www.advancedped.com/wp-content/uploads/2016/07/email_sig_logo_ap.jpg]
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<mailto: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.
_______________________________________________
Ohioaap-practicemanagers mailing list
Ohioaap-practicemanagers at lists.deltaforce.net<mailto:Ohioaap-practicemanagers at lists.deltaforce.net>
https://lists.deltaforce.net/mailman/listinfo/ohioaap-practicemanagers
This e-mail, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed. If the reader of this e-mail is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution or copying of this e-mail is prohibited. If you have received this e-mail in error, please notify the sender by replying to this message and delete this e-mail immediately.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://lists.deltaforce.net/pipermail/ohioaap-practicemanagers/attachments/20210425/64b5d2a9/attachment-0001.htm>