The Michigan State Senate is considering legislation that will require payment parity for telemedicine and I was invited by our state medical society to testify in favor of this legislation. I am super excited to advocate for this. Here are my prepared remarks:
All good points! Good luck today!
Tremendously well put! Wishing you the best today. Know that pediatricians everywhere are grateful & respect your efforts!
Dr. LJM in Santa Barbara, CA
Thank you @tlocke_prp and @lmehler. It was very nerve wracking and quite exciting. I was surprised and disturbed by how little the committee understood what it takes to deliver the care we provide and the level of disdain for health care professionals. That was the only sad part about this.
That’s me testifying!
Thanks for the follow up I’m proud of you! I cannot speak in front of people.
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This is fabulous and good luck.
A comment on one of your lines
But, more importantly, you need to think about a patient encounter with the health system like it is an iceberg and the visit itself is just the visible tip. There is so much work that goes into organizing the care for a patient outside the context of the visit itself- and telemedicine does not do away with any of that work. As well as the isolation from the rest of the practice required to avoid interruptions and confidentiality protection.
I would add a couple of things.
There is good in person care, good telehealth care and good phone call care and mediocre and disconnected(from your primary) care in all those venues
Deductible payments by patients would take a lot of time and we would be required as providers to do that when they are after hours, Plus we are triaging from the beeper to set up telehealth appointments. The technology and its inherent growing pains are time consuming.
The telehealth visits are more risky and have many benefits.
Like all good primary care and good history taking, they are by far the most cost-effective things that are done.
Insurance companies are sitting on bundles of money. Much of it is attributable to pediatric telehealth.
Ability to get care remotely has helped pregnant mothers take care of themselves increasing the average gestational age at delivery. Care of the mothers as well as care of the mothers’ other children remotely help the stress.
I was at a Pediatric Council meeting a few months ago in Massachusetts and an insurance rep asked me what I thought of telehealth and I said “not only should you pay for it, and without time-consuming deductibles, you should commit to it for 2 years because of all our infrastructure investment.” Her answer was she was afraid of over-utilization to which I commented that it was less subject to overutilization than any other type of care. We are not going to order CT scans on head trauma, avoiding ER visits. She countered that she got a claim from an acupuncturist which she thought was ridiculous and unfortunately another pediatrician said ”I wouldn’t pay for it”.
I countered that was both an extreme example which indicates it’s not really a problem and was a reasonable charge. These patients are in pain and the acupuncturist could have soothed the patient by setting up an appointment and teaching him/her acupressure just like we observe an abdominal exam on telehealth to decide if it might be an acute abdomen. It is much cheaper than going to ER for pain.
Remember they all know the cost of everything and the value of nothing.
Let us know how it goes.
Fall River, Mass.
401-864-9690 cell *** best
@WayGaS Thank you for those comments!
And it sounds like we should all be worried- I heard the exact same concern last week about utilization from a BCBSM spokesperson who was testifying against the legislation. She literally said that they saw an increase in visits and were concerned from an “actuarial perspective” and this is why they needed the flexibility to seek out less costly alternatives to in person care.
Here is a follow up essay I wrote to protest that line of thinking: https://docs.google.com/document/d/1ChaHyauIyU7qbWHxVoKXm0wapTin__ruGDvVEFH5nrU/edit?usp=sharing
Thank you. I’ll look that over.
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