By Dr. Clifford L. Deal
We are living in the greatest public health crisis in the last hundred years. COVID-19 has quickly taken hold of Virginia. The Virginia Department of Health announced 1,706 confirmed COVID-19 cases throughout Virginia as of Thursday. We expect the number of cases and deaths to increase.
The challenges faced by doctors in responding to COVID-19 are diverse, complex and downright ominous. A primary care practice in Northern Virginia had staff that contracted the virus. This meant staff had to be quarantined, while non-clinical staff became rightfully concerned about getting infected. Those staff make the difficult decision to stay home since they could not get the protective equipment they needed to work safely.
Physicians, nurses and other health care workers are on the front line of this pandemic. While nearly every American is sacrificing something during this unprecedented time, it is our health care workforce that is sacrificing their own health to treat and help others. Perhaps the most commendable thing about all of this is that health care providers do not view their work as out of the ordinary — it is simply what must be done.
Virginia health care workers need swift action to ensure we will be able to provide appropriate medical care to all Virginians. Already we are confronted with significant challenges — a shortage of personal protective equipment (PPE), staffing and COVID-19 test availability — all pose significant roadblocks for providers and patients.
Losing medical providers at this crucial moment is something that our health care system simply cannot afford. Even providers who are suffering from mild symptoms of COVID-19 will be forced to self-isolate so that they do not risk passing the virus on to patients. If more health care providers become infected and need to stay home, we will not have enough health care staff to care for patients. The global shortage of PPE dictates the need for innovative non-standard solutions. Also, we will need similar drastic changes to how we practice medicine (and this is where telemedicine comes in).
We need Virginia to figure it out.
Physician offices are crucial to keeping patients out of the hospital. Providing virtual care options via telehealth and telemedicine will ensure that physicians are able to address patient demands and best utilize the health care workforce in Virginia. To do this, the citizens of Virginia need the states’ health insurers to continue to follow the lead of Medicare and fully reimburse for innovative care that is happening via telephone, FaceTime, and other apps for all care, not just COVID-19 cases. The last thing we want is for patients to needlessly visit physicians’ offices and those providers be forced to use PPE when resources are so low.
While some health plans are already doing the right thing to respond to this crisis, all Virginia health insurers should:
- Cease prior authorizations and step therapy;
- Allow telemedicine globally for all office visits, except where in-person visits are required, including preventive care codes;
- Fully reimburse at in person rates;
- Allow providers to establish new patient relationships via telemedicine, whenever possible;
- Allow multiple technology platforms to perform telemedicine; and
- Reduce copays for patients to they can quickly access care
We know many health plans are trying to do the right thing and work cooperatively with physicians. We all must adapt rapidly in this critical time.
Many Virginians are suffering now or will suffer in this crisis.
Unnecessary administrative roadblocks to patient care compound the suffering and place us all at higher risk. Health care workers and hospitals are rising to this challenge in unprecedented, sometimes uncomfortable ways.
We need the business side of health care to do the right thing and partner with us for innovative solutions in this time of greatest need.
Clifford L. Deal III, MD, FACS, a Richmond general surgeon, is the president of the Medical Society of Virginia.