Overcoming Common Remote Patient Monitoring Misconceptions
A version of this article first appeared in Chief Healthcare Executive
With the pandemic accelerating the adoption of telehealth and digital health, healthcare providers have experimented with various tools and platforms in order to figure out what’s best for patients. In doing so, they have run into various misconceptions around the adoption of these technologies, including myths about remote patient monitoring (RPM).
Before we dig into these misbeliefs about RPM, let’s consider how we’ve gotten to where we are now. Until the onset of the COVID-19 pandemic, providers had been slow to adopt RPM, even after CMS first added RPM reimbursement codes in 2018. Without being able to see patients regularly in person during the pandemic, RPM became a valuable tool for patient care, particularly for those with chronic diseases. Then, and now, RPM helps providers track blood pressure, blood sugar, blood oxygen, and respond proactively to changes that could impact a patient's health – all while the patient remains in the comfort of their own home.
Managing these chronic conditions remotely helps to prevent complications and costs related to each disease. A KLAS Research report noted that 17% of healthcare organizations achieved cost reductions by using RPM. Results like these encourage more practices to adopt RPM.
According to the Digital AMA Health Research report, provider adoption of RPM grew from 12% in 2016 to 30% in 2022. Within two years, it is expected that more than 70 million U.S. patients or 26.2% of the population, will benefit from some kind of RPM.
Even with this projected growth, there are a few common misconceptions among practices that can deter from building on or growing RPM programs. Keep reading to learn about these misconceptions and how they can be overcome:
#1:The 20 minutes required in CPT 99457 has to be live interaction with a patient.
There has been confusion around this CPT code for a while. The Centers for Medicare & Medicaid Services (CMS) clarified in early 2021 that interactive communication must contribute to the 20 minutes, but is not the only activity that needs to be included. A practitioner can also include time spent reviewing and analyzing the patient’s RPM data and determining how to change care management accordingly. Furthermore, because this can be billed under general supervision, a third party care management team can be the one interacting with the patient, or reviewing and analyzing data.
#2: The devices are not covered by insurance, so I cannot afford to offer Remote Patient Monitoring
In order for remote patient monitoring to work, data must transmit from the device to the software used by a clinic. To the benefit of all, many providers have found that cellular-enabled medical devices are preferable to Bluetooth-enabled devices, because the data can be transmitted without downloading or pairing a new app to the patient’s smartphone. However, many of these home medical or cellular connected devices are not currently covered by insurance. Despite this, with an average of ~$100/device and the potential to be reimbursed an average of $133 in the first month of RPM, most providers realize the revenue-based and clinical benefits of covering the cost of these devices for their patients given their ease of use and reliability -- knowing it will drive long-term success resulting in better patient engagement and data reliability.
Insurance can now cover the more sophisticated medical devices such as Continuous Glucose Monitors, which can also be used in RPM programs. Additionally, insurance is beginning to expand for digital therapeutics, and the reimbursement policy around the newer Remote Therapeutic Monitoring codes seems to be following a similar iterative path that RPM has.
#3: Remote Patient Monitoring programs must use expensive kits
We often hear concerns from providers that are newer to RPM that kit-based models are too expensive. Under this model, patients receive bundled devices, and due to this, (1) the RPM reimbursement does not offset the cost of paying for the devices upfront and (2) providers have to loan them to patients and then retrieve them once program participation is done. Most patients have one primary health challenge that would benefit from intensive management and focus; therefore, not all devices in a kit are clinically necessary and will just add on additional cost. By using the right device for the right patient or chronic condition rather than a blanketed approach, providers can save money while delivering a more personalized approach that improves patient outcomes.
All of the misconceptions above have stemmed from valid concerns, but as you can see, various solutions have been developed and advanced to address these worries. The continued expansion and use of remote patient monitoring is creating more accurate data, redacted costs and better patient experience and outcomes.
Rimidi’s integrated approach to remote patient monitoring was built to support multiple disease states and to help providers meet the needs of patients holistically. With the right partner in place, misconceptions about RPM can be overcome, further demonstrating the importance of RPM and the many benefits it provides.
Looking ahead, understanding options within the reimbursement landscape will also be critical when it comes to implementing an RPM program. For additional RPM policies and reimbursement information, see the 2023 Medicare Physician Fee Schedule Final Rule.
Contact our team today if you have additional questions or would like to start your RPM journey with Rimidi.
