Due to the COVID-19 pandemic, nearly everyone is somewhat familiar with the benefits of remote patient monitoring (RPM), which the American Medical Association (AMA) defines as “a digital health solution that captures and records patient physiologic data outside of a traditional healthcare environment.”
Practices that offer RPM services can:
- increase the availability of care;
- reduce in-office flow of patients;
- proactively manage the conditions of patients with chronic diseases;
- increase patient engagement with their own self-care practices and care teams; and
- generate significant and, importantly, consistent reimbursements.
Not surprisingly, RPM is now on the verge of becoming the new normal. A 2021 survey of hospitals and clinics found that 20% and 23%, respectively, had either already adopted RPM or planned to do so within 12 months. Physicians, however, have been somewhat slow to adopt RPM; a recent Medical Group Management Association poll of more than 500 healthcare leaders found that 75% of medical practices do not yet offer RPM services.
Why the Hesitation?
Despite the increasing prevalence of RPM, many physicians remain on the sidelines because of misconceptions about reimbursements and how to get started. Here are the facts.
Private payors will reimburse for various RPM services. In fact, 74 are already doing this, and some pay more than Medicare.
Physicians do not have to provide services for all the RPM codes to get paid. CMS has assigned a unique CPT code for payors to use for each discrete RPM action. For example, for setting up a patient for RPM (eg, syncing a diabetes patient’s glucose meter to an RPM platform), physicians can submit a one-time claim for approximately $19. For each patient that synchs their data in a month, they can submit a claim for approximately $56; another approximately $56 monthly claim can be submitted for analyzing that data.
These payments can quickly add up. If a practice billed just once a month for synching and analyzing data for 1,000 patients, the monthly reimbursements would be $112,000.
RPM programs can be easily implemented and operated. The AMA’s 12-step RPM Playbook provides detailed guidelines, noting that a key to success is finding a vendor “who will be a long-term partner and not just someone to execute a transaction.” It also recommends that the RPM platform you select should be able to capture the data elements of most importance to your clinicians and patients while easily integrating with your current IT landscape.
Time to Get in the Game
RPM is the cresting wave of the future—a win-win-win for providers, payors, and patients likely to become as essential to healthcare as mobile phones are to modern life. Consider the following.
- By 2024, 30 million US patients are projected to be using RPM tools to manage their health.
- In a 2022 survey of 100 US medical practice leaders, 66% indicated RPM improves patient outcomes.
An RPM program offers medical practices a unique opportunity to improve patient care, engagement, and satisfaction while generating sizable and consistent revenues. Practices able to seize the moment will gain a competitive edge in attracting and retaining tomorrow’s patients who will demand RPM as a standard of care.