<div dir="ltr">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. <div><br></div><div>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.</div><div><br></div><div>Mike</div><div><br><div><br></div><div><br clear="all"><div><div dir="ltr" class="gmail_signature" data-smartmail="gmail_signature"><div dir="ltr">Michael Chamberlin, M.D., FAAP<div>Pediatric Assoc. of Mt Carmel</div><div>4371 Ferguson Dr</div><div>Cincinnati, OH 45230</div><div>513-752-3650</div><div>513-752-3387 (fax)</div><div><br></div></div></div></div><br></div></div></div><br><div class="gmail_quote"><div dir="ltr" class="gmail_attr">On Sat, Apr 24, 2021 at 11:46 AM jprice3 via Ohioaap-practicemanagers <<a href="mailto:ohioaap-practicemanagers@lists.deltaforce.net">ohioaap-practicemanagers@lists.deltaforce.net</a>> wrote:<br></div><blockquote class="gmail_quote" style="margin:0px 0px 0px 0.8ex;border-left-width:1px;border-left-style:solid;border-left-color:rgb(204,204,204);padding-left:1ex"><div dir="auto">Thanks Art. <div>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)<br><br><div dir="ltr">Sent from my iPad</div><div dir="ltr"><br><blockquote type="cite">On Apr 24, 2021, at 10:32 AM, Arthur Lavin <<a href="mailto:alavinmd@gmail.com" target="_blank">alavinmd@gmail.com</a>> wrote:<br><br></blockquote></div><blockquote type="cite"><div dir="ltr"><div dir="ltr"><div class="gmail_default" style="font-family:verdana,sans-serif">Thanks for this Jon,</div><div class="gmail_default" style="font-family:verdana,sans-serif"><br></div><div class="gmail_default" style="font-family:verdana,sans-serif">What an urgently important need!</div><div class="gmail_default" style="font-family:verdana,sans-serif"><br></div><div class="gmail_default" style="font-family:verdana,sans-serif">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.</div><div class="gmail_default" style="font-family:verdana,sans-serif">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.</div><div class="gmail_default" style="font-family:verdana,sans-serif"><br></div><div class="gmail_default" style="font-family:verdana,sans-serif">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.</div><div class="gmail_default" style="font-family:verdana,sans-serif"><br></div><div class="gmail_default" style="font-family:verdana,sans-serif">Arthur</div><div><div dir="ltr"><div dir="ltr"><table style="border:none;margin-top:20px;font-family:helvetica"><tbody><tr width="100%;"><th rowspan="6" style="width:188px;border-bottom-style:none;border-right-width:1px;border-right-style:solid;border-right-color:rgb(0,47,64);padding:0px 10px 0px 0px;margin-top:10px"><img src="http://www.advancedped.com/wp-content/uploads/2016/07/email_sig_logo_ap.jpg" width="188px" height="95px"></th></tr><tr><td style="margin-top:10px;padding:0px 3px 0em 20px;border-bottom-style:none;font-size:0.8em;font-weight:600;color:rgb(0,47,64)">Arthur Lavin, MD, Fellow of the AAP<br></td></tr><tr><td style="padding:0px 3px 0px 20px;line-height:14px;border-bottom-style:none;font-size:0.6em;color:rgb(0,47,64)">3733 Park East Drive, Suite 102, Beachwood, OH 44122</td></tr><tr><td style="padding:0px 3px 0px 20px;line-height:14px;border-bottom-style:none;color:rgb(0,47,64);font-size:0.6em"><span style="font-weight:600">P</span> 216.591.1515 <span style="font-weight:600;padding-left:9px;padding-right:15px">|</span><span style="font-weight:600">F</span> 216.591.1544</td></tr><tr><td style="padding:0px 3px 9px 20px;border-bottom-style:none;color:rgb(0,47,64);font-weight:600"><a href="http://www.advancedped.com/" style="color:rgb(0,47,64);font-size:0.8em" target="_blank">www.AdvancedPed.com</a></td></tr></tbody></table></div></div></div><br></div><br><div class="gmail_quote"><div dir="ltr" class="gmail_attr">On Fri, Apr 23, 2021 at 1:20 PM Jon Price via Ohioaap-practicemanagers <<a href="mailto:ohioaap-practicemanagers@lists.deltaforce.net" target="_blank">ohioaap-practicemanagers@lists.deltaforce.net</a>> wrote:<br></div><blockquote class="gmail_quote" style="margin:0px 0px 0px 0.8ex;border-left-width:1px;border-left-style:solid;border-left-color:rgb(204,204,204);padding-left:1ex">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. <br>
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