What Is Remote Patient Monitoring, in Simple Words?
Before diving into the financial benefits, let's agree on what remote patient monitoring is. In the past, patients required training to check their vital signs at home, and they would have shared that data by phone with their care provider. Today, technology fills these gaps, making it easy to collect and share data with little to no training. In short, RPM eliminates barriers and helps patients with chronic conditions achieve better outcomes.
Who Needs Remote Patient Monitoring?
Patients with many needs and conditions use remote patient monitoring, including:
- Chronic Obstructive Pulmonary Disease (COPD)
- Congestive Heart Failure (CHF)
- High Blood Pressure (Hypertension)
- Chronic Kidney Disease
- Post-Surgical Care
- Prenatal and Postpartum Care
These are just some of the many conditions where a daily record of vital signs is an incredible asset for patients and their doctors. However, when vitals are checked only during an appointment, the actual day-to-day reality might not be apparent since something could vary more frequently between scheduled visits. In addition, if a patient's blood pressure, blood sugar, or other metrics are stable during the appointment, that can lead to a sense of security that could potentially be a risk if left unmonitored.
On the other hand, remote patient monitoring keeps a record of this information daily. As a result, RPM can help a patient and clinician decide if the patient needs to come to the office or emergency room based on what they're experiencing at that time.
Perhaps best of all, the patient doesn't have to leave home to get this fantastic service and can continue to rest and recover. They are also taking a more active role in their wellness and may feel better, more secure, or more optimistic due to RPM.
Remote Patient Monitoring Cost and Benefits FAQs
Primary care providers may be all-in on RPM's efficiency and effectiveness but have concerns about cost. Let's look at how RPM can help care providers and patients save money and what happens on the insurance side to cover these services.
What Are the Benefits of Remote Patient Monitoring?
Remote patient monitoring provides a return on investment through reduced readmissions, cutting practice costs, and lower physician turnover.
Unplanned hospital readmissions cost $15-20 billion annually in the United States. Of these, 27% were potentially avoidable. In some cases, better communication with the patient about their care goals and more robust support at home can keep patients from returning to the hospital. In the fiscal year 2021, 83% of the 3,046 hospitals evaluated by the Center for Medicare and Medicaid Services (CMS) were penalized for having high readmission rates (under MSSP or ACO participation by providers). The 0.64% reduction in payment for each Medicare patient may not sound significant to some. However, this adds up to hundreds of thousands of dollars in lost revenue per hospital, and CMS expects to save over $500 million annually. RPM can help hospitals reduce preventable readmissions and potentially avoid these penalties!
Cutting Costs Of Practice
Studies and pilot programs have shown that remote patient monitoring reduces the cost of medical practice and patient care. For example, one Pennsylvania hospital saved over $8,000 per patient yearly when they used the technology for patients with heart failure. The same patients only experienced 2% disease progression in their condition, compared to 30% in the control group. In another study, they provided new mothers with a take-home blood pressure cuff, and the RPM app reduced one-week postpartum visits by 57%. Of the participants who went through this program, 88% returned for their six-week follow-up, compared to the national average of 40%. RPM helps caregivers meet with patients at the right time for the right reasons while also achieving cost savings by reducing unnecessary visits.
Lower Physician Burnout
Physicians experience burnout, perhaps at a higher rate than some other professions. Pre-COVID studies showed that more than 50% of physicians were coping with burnout, which has undoubtedly increased. Time pressures, low control of their work pace, and the need to manage electronic medical records are causing their burnout. RPM can address these causalities of burnout, creating more room in the physician's schedule by avoiding unnecessary appointments for plain data collection. Apps like Harmonize Health collect and transmit patient health data through HIPAA-compliant portals that automatically update medical records without saving sensitive patient data. RPM helps doctors and other clinicians experience less stress and reduces the cost of re-hiring due to turnover.
Is Remote Patient Monitoring Cost-Effective For The Patient?
Remote patient monitoring is a financial benefit to the medical practitioner. But is RPM cost-effective for the patient as well? Absolutely. RPM allows patients to save money in small and large ways. In the short-term and on a smaller scale, they save money on expenses like gas commuting to appointments and co-pays or emergency room expenses. In the long term, RPM helps the patient take a proactive approach to their health because they are more aware of their disease progression day-to-day. This awareness may lead to less time in the hospital and money saved on more expensive treatments or extra medication. In addition, more frequent check-ins with the patient around their chronic conditions allow for better health-related quality of life (HCQoL) insights. Finally, for those on Medicare Special Needs Plans (SNP), remote patient monitoring helps collect the necessary Healthcare Effectiveness Data and Information Set (HEDIS).
Who Pays for Remote Patient Monitoring?
RPM is a monthly program you can bill to insurers, including both Medicare and private insurers. Providers can also bill RPM as fee-for-service, provided they meet with the patient long enough and often enough. In all these cases, a physician or other qualified health professional must order the RPM, and there must be a record of the patient's verbal or written agreement to RPM.
With that explained, now we'll talk about both Medicare and private insurers.
Does Medicare cover RPM?
It's no secret that Medicare often reimburses hospitals and physicians less than the cost of providing care. For example, in 2020, hospitals were underpaid $100 billion by CMS. Remote patient monitoring billing is no exception to these rules. In addition, Medicare will usually only cover RPM for high-risk populations, whether their condition, location, ability to get to the doctor or something else is presenting the risk. We can share a breakdown of the typical Medicare repayment opportunities for remote patient monitoring in 2022.
- Medicare will cover $19 for the patient's enrollment into the RPM program under CPT code 99453, which includes providing them with the necessary devices. Our custom RPM device kits at Harmonize Health have a complete replacement guarantee. If the devices stop working, we replace them for no additional cost.
- Medicare will cover $56 monthly to monitor and maintain the devices under CPT code 99454. However, the patient must submit at least 16 days of readings to qualify. Our easy-to-use app takes the patient an average of just three minutes to submit their vitals and other measurements, which is how we achieve 97% monthly retention among patients, making the reimbursement for the service more likely to providers.
- Medicare will cover another $50 a month for the interpretation of the data by a qualified medical professional under CPT code 99091 as long as they spend at least 30 minutes on this task every 30 days. The AI features built into the Harmonize Health app can support these efforts and alert care providers when attention is needed based on the day's inputs.
- Medicare will cover a $50 reimbursement for 20 minutes of communication with the patient or caregiver under CPT code 99457. This contact could be a discussion about the data they have sent or any resulting edits to the care management plan. Should this conversation take longer than 20 minutes, Medicare will provide an additional $41 reimbursement for 20 more minutes under CPT code 99458, but that is the most. We build a real-time video call functionality into our platform to make starting these critical discussions as simple as a click.
Care providers could be reimbursed $156-$197 monthly per patient for RPM by Medicare.
Do Other Insurers reimburse remote Patient Monitoring?
Yes, RPM can be reimbursed by private insurers as well, who usually pay around 220% more than Medicare. Private plans may also be more likely to cover RPM for patients not in a critical phase of their health or other needs.
Is Remote Patient Monitoring Profitable?
Yes, remote patient monitoring is profitable financially and in its outcomes for patients. This technology achieves $7,000 or more in savings per patient each year. That's the money going back into your pocket! It also returns a profit on time for all parties involved. Nurses aren't on the phone calling patients all day. And individuals with chronic conditions aren't stressed out in the car trying to get to an appointment when they could have spent three minutes at home checking their vitals and getting on with their day.
Is Remote Patient Monitoring Worth It? Obviously!
Harmonize Health is proud to have created a remote patient monitoring platform that delivers exponential return on investment. We help care providers make more money by improving patient outcomes and increasing reimbursement. Through this model and with our partnership, users have achieved impacts like:
- 60% reduction in false alert volume
- 50% reduction in bed days
- 70% increase in patient engagement
- 40% increase in patient satisfaction
These numbers translate to more income, happier patients, and more referrals to keep the business growing. As you grow, Harmonize Health is there with you. Along with the devices and technology, our users also get the support of our patient engagement team. We share behavioral coaching and educational content directly with patients because we want this service to play a positive and helpful role in their daily lives. That delivers more ROI to the care provider without investing more time and thought.
We are confident we can help engage and monitor all patients, even those who don't know much about technology. Learn more about how we can streamline your RPM, integrate with your EMR system, and overall have a lot more A-OK around your facility.