Health

Reimbursement for remote patient monitoring can help improve patient outcomes


Remote patient monitoring can help providers extend care to patients in underserved areas and improve outcomes, but only if it is a reimbursable service.

During the COVID-19 pandemic, the number of Medicare beneficiaries monitoring patients remotely has skyrocketed, according to an August 2022 study in JAMA Internal Medicine. According to the study, between February 2020 and September 2021, the use of remote patient monitoring increased from 91 requests per 100,000 subscribers to 594 requests per 100,000 subscribers.

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But as adoption increases, the technology return faces an uncertain future. The Centers for Medicare & Medicaid Services expanded billing for remote patient monitoring since 2018 by adding a payment code that covers some services in Medicare fee-for-service health plans. . However, the reimbursement value for some of those codes fell by more than 10% on the 2023 Medicare Physician Fee Schedule and could fall again in 2024. In February, six of the seven Medicare Administrative Contractors, Medicare reimbursement administrators on behalf of CMS, met to discuss the future of remote patient monitoring reimbursement.

The end of the public health emergency on May 11 will remove some temporary flexibility around remote patient monitoring, such as not enforcing sanctions under the law. Against Fruits Act to waive copayments for these services. Flexibility helps providers make remote patient monitoring more cost-effective.

“It will put remote patient monitoring companies in a predicament and force them to immediately begin, at the end of the public health emergency, to begin discharge and live patients. combined with the potential consequences of reduced patient adherence,” said Thomas Ferrante, an expert. Healthcare attorney in Foley and Lardner.

Advocates of remote patient monitoring say there is growing clinical evidence supporting broader permanent coverage.

“This is not the right time for Medicare to slow down.” [reimbursement for remote patient monitoring],” said Chris Altchek, CEO of remote patient monitoring technology company Cadence. “It is really getting started. It really has an impact. It really increases health equity. If they slow it down now, it will send a really bad signal to other payers who will follow Medicare’s lead.

Service providers such as the University Medical Center are using remote patient monitoring to extend care to chronic care patients who struggle to see their doctor regularly. doctor. The University Medical Center uses devices from Boston-based startup Ceras Health to monitor the vital signs of patients with diabetes, high blood pressure, and other chronic conditions.

Dr Richard Friend, director of the University of Alabama Medical Center, said: “The greater the chance that the people who pay us come in contact with the patient and possibly get reimbursed, the more likely there is to be a refund. opportunity for us to make a difference in patient care. clinics serving rural patients throughout Alabama.

In a state like Alabama, where 80% of counties are located in rural areas and some counties don’t have critical access hospitals, remote patient monitoring can make a big difference. But for the program to work, reimbursement is required to cover the costs of provisioning and managing the device. Friend says the cost savings speak for themselves.

“A device that can cost $100 will end up saving the healthcare system thousands of dollars,” says Friend. “We must be forward-thinking and continue to be patient-centered to achieve the goals that people across the country want to achieve, which is better care with the right resources in a cost-effective way. expense.”

Southwest Community Health Center in Bridgeport, Connecticut, uses Chicago-based TimeDoc Health’s remote patient monitoring technology to monitor blood pressure and other vital signs of hypertensive patients. Dr Dara Richards, chief medical officer, said the program was able to engage about 1,000 hypertensive patients and had seen a more than 30% improvement in blood pressure control. More than 60% of patients had their blood pressure under control.

“The patients are happy and very engaged,” says Richards. “We can see with remote monitoring where we have asked them to check their blood pressure daily, preferably twice daily, and we can see from the portal that they are doing this. there. We monitor compliance rates and they are very high.”

Despite this success, the show’s future is somewhat uncertain. The remote monitoring aspect of the program is funded in part by a grant from the Health Resources & Services Administration. Richards said the federally qualified medical center is looking for additional funding opportunities to maintain the program, otherwise the center would not be able to monitor and receive alerts when someone’s blood pressure is too high. .

Industry stakeholders remain optimistic.

“Big hurdles will come with copay cost sharing, but there are also other revenue opportunities and strategies like Medicare Advantage,” says Ferrante. “The rule is that if a Medicare fee-for-service service pays for it, then the Medicare Advantage plans must pay for it.”

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