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How Remote Patient Monitoring Benefits Your Patient Population

Since the Centers for Medicare and Medicaid Services (CMS) began providing standalone reimbursement for Remote Patient Monitoring (RPM) just over three years ago, RPM has grown from an experimental remote care technology to a critical care offering for thousands of healthcare providers throughout the United States. RPM can help practitioners expand their practices along with their ability to drive outcome-positive changes for patients, managing everything from chronic conditions to acute illnesses.

The opportunity for RPM was born from clinical need. RPM has proven to drastically reduce hospital readmissions for heart failure and chronic obstructive pulmonary disease (COPD) patients. These concrete examples offer a way for primary care providers to become more proactive in the care of their patients and reward them for preventative measures.

Additionally, RPM can be a real benefit to care plan adherence for the U.S.’ rapidly aging population. A study on adherence and usability published by the NIH on RPM for older adults found that participating in a properly designed RPM program may help older adults with chronic conditions live longer in their own homes. In other words, RPM has been shown to produce positive results for providers and payers, both clinically, from a cost savings perspective and in terms of the patient experience.

How RPM Works

RPM involves the collection and analysis of patient physiologic data used to develop and manage treatment plans related to chronic and/or acute health illnesses or conditions.

There are four key components to RPM:

  1. Order, consent, education and setup: The provider orders RPM, and the patient gives consent to participate. The patient is then educated on the device and program.
  2. Transmission and collection of physiological data: The patient takes his or her readings, and the data is transmitted to a HIPAA-secure platform.
  3. Evaluation, management and engagement: Care teams evaluate and manage the patient’s care plan and engage with their patients.
  4. Billing and reimbursement: Specific CPT® codes as they relate to RPM are billed.

Benefits of RPM

The benefits of RPM extend from your patient population to your staff satisfaction and workflows. Here are four key advantages of implementing a solid RPM program: 

  1. Improved Care and Health Outcomes 

Improved care and health outcomes are among the top benefits of RPM programs. Studies demonstrate that patients who participate in remote monitoring programs experience reduced hospital admissions and emergency room visits. Additionally, patients have seen improvements in chronic care conditions.

  1. Stronger Patient Engagement

Strong RPM programs encourage stronger patient engagement and empower patients to take an active role in the improvement of their conditions by literally putting measurement tools in their hands. Using digital tools and providing on-demand experiences with which patients are familiar in almost every other area of their lives further drives patient engagement with providers and their care plans. 

  1. Expanded Access to Care

Although RPM is not a replacement for office visits, it can be used as a method to expand access to care. The data generated by remote at-home monitoring equipment can supplement data pertaining to chronic conditions, ultimately improving the potential of patient outcomes.

  1. Opportunity for Reimbursement 

RPM also opens an opportunity for reimbursement. The figures below represent Medicare’s 2021 national average payment amount for the five remote monitoring codes:

CMS Remote Monitoring CodeAverage Payment per Patient
99453$19
99458$41
99457$51
99091$57
99454$63

State, local and commercial reimbursement amounts vary. It’s a good idea to consult with local payer representatives or a local Medicare Administrative Contractor (MAC) to get a more accurate sense of exact reimbursement rates for any given geographic region.

Quality Matters

Choosing the right RPM program might seem like a daunting task. It can be tempting to simply choose the least expensive option. However, it’s wise to take time to research which options will work best for you and your patients. The level and quality of customer service and seamless technology can have a big impact on your RPM experience. To learn more about Optimize Health’s partnership with Epion Health that integrates Remote Patient Monitoring into the Epion Health virtual care experience, request a demo, and see how RPM can work for you.

By Jeff LeBrun, Co-founder and CEO, Optimize Health. Optimize Health is solely responsible for the content of this article.