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

[Michael Chamberlin]

I have seen many examples of improved care due to the availability of
telehealth. I have a family with poor access to transportation.  They were
able to come into the office even though we are open until 8 pm during the
week.  They thought that their only option would be the ER that night.  We
arranged a telehealth appt for their child and avoided an expensive ED
visit.  Also, we have improved follow up with our patients with mental
health issues.  This along with other changes (focusing on depression
screening) has improved the care that these patients receive.  We have done
telehealth visits with the parent at work so that they have not had to miss
work.  I would think that employers would see the value in this.

As Arthur mentioned, rashes are another great example of a problem that can
be properly addressed during a telehealth visit so that a more expensive ED
or UC visit can be avoided.

Mike



Michael Chamberlin, M.D., FAAP
Pediatric Assoc. of Mt Carmel
4371 Ferguson Dr
Cincinnati, OH  45230
513-752-3650
513-752-3387 (fax)



On Sat, Apr 24, 2021 at 11:46 AM jprice3 via Ohioaap-practicemanagers <
ohioaap-practicemanagers at lists.deltaforce.net> wrote:

> 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 <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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