braun: will changes to virtual care billing curtail equal access?
physicians and others continue to question recent chang...
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physicians and others continue to question recent changes to virtual medical care in ontario.
a group representing kixcare, a company providing direct virtual health care for children and families, has launched a campaign in response to the new agreement reached between the ontario medical association and the ministry of health.
save virtual care allows consumers to register opposition to these changes.
on paper, it looks as if virtual care can continue uninterrupted. the new agreement, however, changes the fee structure in a fashion that makes it financially untenable for doctors to continue with patients they cannot see in person.
like others who have expressed concern over these changes, those at kixcare believe this jeopardizes care for families in rural or remote parts of the province and those with no family doctor.
the online campaign lists some of the practical benefits of virtual care: no time off work, parking hassles, lengthy waits or unnecessary emergency room visits are involved.
changing the billing for virtual care was presented as a way to ensure that doctors go back to in-person visits — a patient-centred approach. it’s tough not to be skeptical.
daniel warner, ceo of kixcare, said that during covid every ontarian who wanted medical care had equitable service, because of virtual visits.
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“virtual care helps keep people out of the system who don’t need to be seen in the system,” said warner in a recent interview, and anyone who has waited anxious hours in the emergency room of a hospital because there was no other option can relate.
for many, said warner, online service meant far more prompt care than before the pandemic.
“virtual is the digital front door of health care,” he said, noting that personnel at sick kids’ hospital and other hospitals are very much in favour. “it’s the right decision for patient access and patient outcomes.
“virtual care should be widely supported.”
it’s not that virtual care will cease to exist, but under some circumstances doctors will be paid a pittance for their work — and that may kill any incentive to continue.
“you can’t just put the virtual care genie back in the bottle, when all the information says these important modalities should be supported, for reasons of health and practicality. emergency rooms should be for emergencies,” said warner.
any change to virtual care will potentially penalize those who are most in need of regular, accessible care: those who have no doctor and those who live in remote areas.
“why doesn’t the oma support new modalities? other provinces aren’t doing this,” warner said.
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in a statement, the oma said that the new agreement between doctors and the province includes a permanent framework for virtual care by phone and video — instead of the temporary set-up during covid.
“the physician services agreement requires an existing physician/patient relationship in order for physicians to bill comprehensive virtual care codes.
“where there is no existing physician/patient relationship, physicians will be considered to be providing a ‘limited virtual care service’ funded at a rate of $15 per telephone visit.”
the ministry of health stated, “the physician funding model agreed to under the new physician services agreement will support all patients continuing to have access to clinically appropriate virtual care, where virtual care is the appropriate modality of service. all medically necessary virtual care services will continue to be insured under the ontario health insurance plan (ohip) when the necessary requirements have been met.
“physicians will still be paid for those services, and also continue to have the option of seeing the patient in-person to be paid at the full value of fee for the insured service listed in the schedule of benefits.”
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the option of seeing the patient in-person — in order to be paid properly — is not always an option. how long before doctors just can’t afford to “see” some patients at all?
meanwhile, covid isn’t over yet. for their own (and the doctor’s) safety during the pandemic, many people haven’t seen a physician in person for more than two years.
given the current infection rates in ontario, why would they rush back now?
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