The use of remote patient monitoring (RPM) has surged in recent years. And, as the number of care management models using this technology also increases, more and more healthcare organizations are seizing the advantage of RPM to improve outcomes and enhance revenue. But with so many options on the market today, how can leaders know they’re choosing the right remote patient monitoring services for their facilities?
What is remote patient monitoring, and how is it different from telehealth? Find out here
Finding the Right Remote Patient Monitoring Services for Your Organization
Step 1: Define your patient population
Remote patient monitoring is used for a variety of purposes today, providing a true spectrum of possible patient care solutions. Making sure that you’re choosing the right solution in any given situation means starting out with a full understanding of just what you need from it. And that begins by deciding which patients would best benefit from new remote patient monitoring services.
The most common patient populations are those with chronic conditions, followed closely by those with another high-risk condition (such as recovering from surgery or injury). Because they so frequently have chronic conditions, and because they’re increasingly demanding to age in place as they get older, seniors are also frequently the focus of RPM programs, too.
Here’s a closer look at each of these populations, and how RPM is used to more effectively treat and manage them.
Over the past decade, RPM has been used most frequently to provide care for patients with chronic diseases. These conditions include cancer, heart disease, hypertension, kidney disease, diabetes, Alzheimer’s disease, dementia, obesity, drug abuse, asthma, depression, and many others.
Taken together, these are some of the country’s deadliest conditions — and the costliest. “More than 877,500 Americans die of heart disease or stroke every year — that’s one-third of all deaths,” according to an assessment on chronic disease from the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).
“Each year in the United States, more than 1.7 million people are diagnosed with cancer, and almost 600,000 die from it, making it the second leading cause of death,” the authors add. “The cost of cancer care continues to rise and is expected to reach more than $240 billion by 2030.”
Remote patient monitoring can improve the treatment of patients with chronic conditions by recording high-quality data, and then transferring it seamlessly and securely to an organization’s electronic health record (EHR) system. The result is better-informed care teams who can offer more effective early interventions to keep chronic care patients healthy and out of the hospital.
Using remote blood pressure monitors, pulse oximeters, weight scales and other RPM devices for continuous monitoring or near-continuous monitoring of patients, healthcare professionals can keep a closer watch on vital signs like heart rate and respiration rate, as well as other important readings like blood pressure, blood glucose levels, blood oxygen level, blood sugar levels and weight.
Looking for more info? Take a deeper dive into remote patient monitoring devices here
Since 2018, CMS has offered reimbursement for the use of these devices to treat patients with chronic conditions. Eligible billing practitioners can use CPT® codes 99091, 99453, 99454, 99457 and 99458 to receive payment for setting up those devices and creating a treatment plan around their use. Up to 60 minutes of compensation is also available for patient consultation, which can be in-person visits, video visits and phone calls. You can get all the details on current RPM codes and reimbursement rates here.
The CMS’ Chronic Care Management (CCM) care management model offers another way for providers to receive reimbursement for using RPM to treat chronic care patients. Eligible practitioners can use CPT codes 99490, 99491, 99487 and 99489 and HCPCS Code G0506 to provide care to patients with two or more chronic conditions. Check out the current CCM codes and reimbursement rates here.
In general, the codes for CCM cover time spent by a physician or other qualified healthcare provider (like a nurse practitioner or physician assistant) in assessment and care planning for patients with chronic or complex chronic conditions, which generally includes the use of RPM devices to inform that care planning. Because the RPM care management model covers device setup and use, providers can often receive reimbursement for both models for the treatment of a single eligible patients.
Another way to receive reimbursement for using RPM to care for patients with chronic conditions is with the Transitional Care Management (TCM) and Principal Care Management (PCM) models. The first covers the first three months of a post-discharge patient, and the latter covers the subsequent three- to twelve-month period, and can be used to provide care for a patient with a single chronic or high-risk condition.
As with Chronic Care Management, TCM and PCM can make use of remote monitoring to provide care for patients with chronic conditions. However, these models have a larger scope, and can also be used for the treatment of patients with a single high-risk condition, such as recovery from a serious injury or sensitive surgical procedure.
The goal of TCM is to transition a patient safely away from hospital-based acute care, and the PCM model to best avoid patient deterioration and the onset of new comorbidities. Using remote patient monitoring services to better manage these sensitive patients offers healthcare organizations another method for boosting outcomes while lowering cost.
And because they’re designed to keep people out of the hospital, CPT codes 99427, 99426, 99425, 99424, 99495 and 99496 can be used in the home, or in a nursing or long-term care facility, using remote patient monitoring software and devices. You can get the current TCM codes and reimbursement rates here, and the current PCM codes and reimbursement rates here.
The American population is trending older, with seniors set to outnumber people aged 18 and younger by 2034 — a first in United States history. And, according to the CDC’s National Center for Health Statistics, 87.6 percent aged 65 years and over have at least one chronic condition, and almost 25% have three or more.
For many healthcare organizations, the ability to provide quality senior care as cost effectively as possible is an absolute essential. Remote patient monitoring services have long been used to meet this need, and not just because many older Americans have chronic comorbidities. By offering a close watch on vital signs and other key indicators, older adults can enjoy more attentive care without the added expense of hospitals stays and office visits.
In addition, RPM gives seniors the option to age in place during their retirement years — something that older Americans increasingly value. Almost 80 percent of adults aged 50 and over “say they want to remain in their communities and homes as they age,” according to a survey from the AARP. By enabling them to do exactly that, RPM can help drive engagement and satisfaction among senior populations, on top of the improved outcomes that come from better treating chronic illness.
Related: 3 Ways to Improve Senior Care Services with Remote Patient Monitoring
Step 2: Anticipate future need
While the purpose of most remote patient monitoring services is to help organizations with an immediate need, it’s a good idea to think in terms of future use and growth, as well. As the use of RPM can and often does expand to treat additional patient populations, it makes sense to choose an RPM service that can effectively scale up — from a pilot program to a full population, and then on to others.
And, as we’ve seen with the demand for aging in place among older Americans, remote care is also something that today’s patients actually want. So, while today’s needs may be to better treat high-risk patients, tomorrow’s priority could be helping a senior population more comfortable age in place. Since RPM technology can handle both tasks, and a few others, it makes sense to choose a vendor that can readily scale up and adapt to those needs without difficulty or added expense.
The reliability of a potential partner is key here. Especially if you’re choosing a third-party solution, partnering with a remote patient monitoring services provider should take int consideration not only scalability and quality, but also the chances that they’ll still be there when you need them 5, 10 or 20 years down the road.
Step 3: Determine your operational needs
After you know the specific population or populations that you’ll be treating with a remote patient monitoring platform, and what level of future growth you anticipate, it’s time to choose the specific service that best matches your needs. Are your existing operations and workflows better complemented by partnering with a third-party vendor, or building your own an in-house solution?
There are pros and cons to both options. Creating an in-house solution often involves a significant up-front expense in the form of device acquisition and staff training. Yet these can also be seen as wise long-term investments. As outcomes steadily improve, and as the internal team develops better skills in administering remote care, the yields gained from an RPM program will increase each year.
Partnering with a third-party RPM vendor, on the other hand, lets organizations begin with a program that’s already been carefully designed and fully set up, letting them see those returns earlier. With a lower upfront cost and a greater level of expert guidance, these outsourced RPM programs may be better suited to providers without the resources for a large initial investment.
There are other variations, too, including hybrid models. You can get a much more detailed picture of the difference between in-house and outsourced RPM programs here.
Step 4: Final considerations
“Done well, remote patient monitoring can reduce the risk of avoidable hospital visits, long stays and readmissions,” as Sarah Carroll, senior director of the Center for Care Transformation at AVIA, told HealthITNews.
Of course, the operative phrase here is “done well.” There’s no shortage of RPM vendors today, with dozens if not hundreds cropping up in recent years to seize the opportunities of a promising market. But it’s important to assess any future service provider carefully. Anything less than the utmost attention to clinical detail, operational expertise, data security and platform longevity represents a risk to the program’s success, and potentially an organization’s long-term viability.
For instance, can your RPM partner help put the data being monitored to the best possible use? By applying advanced tools like business analytics, artificial intelligence (AI) and machine learning (ML), sophisticated RPM vendors work to assist organizations in continuously improving their operations and workflows. And that, in turn, is likely to fuel additional outcomes, boosting overall ROI.
A seasoned remote patient monitoring services provider with real expertise can also help you navigate other aspects of the program. For instance, federal grants are available to help organizations pay for their initial RPM investment. Expert guidance on what’s available and who’s eligible could help substantially reduce your initial down payment, or even serve as the deciding factor on whether an organization can get their RPM program up and running in the first place.
Find the remote patient monitoring services you need with CareSimple
If you’re looking for more details on how to choose the right remote patient monitoring services to meet your organization’s needs, you’ve come to the right place! Check out the CareSimple RPM Ultimate Guide for everything you need to know about remote patient monitoring — and then some. You can also learn more about the CareSimple RPM platform here, or contact us here to get in touch directly.