Q&A with The Big Unlock: How RPM Can Improve Outcomes
The healthcare market has rapidly evolved in recent years, and it’s our job to make it scalable and better for all stakeholders by leveraging the right tools, insights, and analytics needed at the points of care.
I recently sat down with host Paddy Padmanabhan, founder and CEO of Damo Consulting Inc., for an episode of The Big Unlock podcast, where I discussed the split market between fee-for-service and value-based care and the drive towards sustainability of virtual care models for FQHCs and RHCs.
For healthcare organizations, particularly FQHCs and RHCs considering RPM and transitioning to a value-based care model, I’m sharing some insights into commonly asked questions.
With telehealth and RPM becoming mainstream, what is the current adoption rate for Rimidi’s RPM platform?
It’s been an interesting two years due to COVID-19 and its impact on healthcare delivery. Telehealth and RPM have both seen some major accelerations. But for us, we have worked in this space for a long time and were already focused on continuous models of care before COVID, because that’s what it takes to manage chronic health conditions.
Before COVID, there were barriers such as limited reimbursement and patient copays, which obstructed scalability to a larger segment of the market. Now, the pandemic helped tear the band-aid off for everyone. In general, we work with two different types of organizations: the risk bearing entities for whom this is the most cost-effective and efficient way to deliver good care and achieve their quality measures. And those who still live in a very fee-for-service world have embraced expanded reimbursement to enable them to deliver high quality patient care. It’s still kind of a split market in our experience.
Give us an example of one of your clients who’s used your platform, and the results.
We’re working with a group called Leon Medical Centers in south Florida, part of the Medicare Advantage Group. They use our platform to help patients manage diabetes among their patients.
They target variations for poorly controlled diabetes defined by an A1C over 9, and since using our platform, they’ve been able to get 88% of their patients to their goal by engaging them more intensely through RPM, as well as more holistically because the whole platform is integrated with their Epic EHRs.
It is a challenge putting all the data into systems or wrangling it to make holistic sense of it. What challenges have you had to overcome?
We were very early evangelists of Fast Healthcare Interoperability Resources (FHIR) for the HL7 FHIR data standard, because our vision has always been, how do we get all of this data into a workflow to the point of care? We’ve been on the journey of standardizing APIs for the past 10 years, and interoperability and FHIR have become the dominant standard in that time. Now, we can finally achieve our vision of aggregating data into a consolidated experience for the physician.
Another big part of what we do is clinical decision support. So, while physicians don’t need more information, they need to be able to do the right thing without missing anything about a patient within their workflow.
The pandemic has highlighted the disparities in access to care. Can you discuss how Rimidi’s platform addresses social equity, health equity, and disparities in access to care?
We work with many FQHCs and safety net hospitals, which are caring for those most vulnerable patients in our system who have the most barriers to care. We also know that chronic health conditions tend to over index in these populations. A big part of our business is to enable better access and an enhanced standard of care to those who have the hardest time receiving care. RPM is something new to a lot of those care delivery systems and clinics, but it’s something they really embrace.
There are currently some challenges from a reimbursement point of view. Under Medicare, FQHCs can’t get reimbursed for RPM, so they get grants from the FCC and other private foundations to do this work, which creates a sustainability problem that must be solved, and we’re involved with many others and advocating for that.
You referred to the Federal Grant Program last year which set aside a couple of hundred million dollars, so a number of health systems were able to access it and use it constructively. What needs to happen for this to become a sustainable model?
Two changes concerning the restriction – FQHCs and rural health clinics can get reimbursed for RPM along with providers of care for any other Medicare beneficiary and then, get the alignment of state Medicaid plans. It is a state-by-state kind of a hodgepodge right now, whether Medicaid reimburses, and offering RPM reimbursement is really an on-ramp to practicing value-based medicine.
We have to give these organizations some runway — a couple of years of reimbursing them and giving them a financial model that works to deliver care in this way – is how we can transition them to value-based care models. But we have to give them time to really build the systems and the people in the processes to do that.
To learn more about Rimidi’s platform, please contact a member of our team or request a demo.
