Remote patient monitoring (RPM), while commonly associated with chronic care management (CCM), can drive many other beneficial care management programs — from transitional care to Hospital in The Home (HTH) care and beyond.
But what does this look like in practice, and how can RPM services help providers drive superior health outcomes? We’ll explore the defined care parameters for RPM to dispel any confusion around the major care models and their billing options.
What major care models can RPM serve?
Remote patient monitoring services can support a diverse range of treatments, from acute to chronic conditions, and as such, it can serve several care models, including post-discharge support, CCM, and HTH care.
Healthcare professionals often dedicate their efforts to treating the acute illness that precipitated a patient’s hospitalization; however, once a patient is discharged, they enter a highly critical period of generalized risk. During this time of recovery, they may be vulnerable to a range of adverse health effects — in addition to any lingering effects of their initial illness — due to stress on the body that patients may experience while hospitalized. This condition of generalized risk is often referred to as post-hospital syndrome.
Post-discharge care and RPM can be leveraged to treat singular complex conditions, help maintain patient health, and avoid rehospitalizations due to post-hospital syndrome. Post-discharge care is delivered in two phases: transitional care management (TCM) and principal care management (PCM).
Principal care management
PCM typically picks up from transitional care after the initial 30 days post-discharge and can continue for three to 12 months. This care model aims to stabilize a patient’s condition to avoid escalations or complications and transfer them back to their primary care provider as soon as possible.
As with TCM, PCM and RPM can be used and billed simultaneously. RPM can be leveraged in the same manner to monitor and manage a patient’s condition and medication while supporting regular communication, coordination, and other day-to-day functions.
Transitional care management
TCM typically begins the day a patient is discharged and lasts for 30 days. This medical billing option is meant to reimburse practitioners for treating patients with a complex medical condition during this time period, with the goal of avoiding patient readmissions and ensuring full recoveries.
RPM can be used and billed simultaneously with TCM. This includes leveraging RPM to track a patient’s vital signs and other important data that providers can use to monitor their condition, as well as remote communication to discuss and review the patient’s condition.
TCM and PCM are designed to form a holistic model of care for post-discharge support. Fundamentally, they are extensions of one another, with PCM picking up where TCM leaves off, and RPM can make these transitions more seamless with 24/7 monitoring.
Chronic care management
As mentioned, RPM is most often associated with CCM. They are two distinct reimbursement models but are commonly coupled together.
The main distinction between CCM and TCM/PCM is that, to qualify for CCM, a patient must have at least two chronic conditions, whereas TCM and PCM are only used to treat patients with one chronic condition.
CCM aims to help patients better manage their conditions and prevent them from acquiring another, and it’s designed to cover patient care that happens outside of the traditional clinical office setting. Because chronic conditions can last from a year until the end of life, they require active management, which can lead to high costs. RPM can help lower those costs by enabling active management remotely.
Chronic conditions include congestive heart failure, kidney disease, diabetes, cancer, stroke, multiple sclerosis, and more. Caring for these complex conditions — especially when a patient has two or more — can be challenging, as symptoms may not show themselves in an office setting. With RPM, providers can better track a patient’s conditions while they’re at home to gain a wider picture of their health.
This includes using RPM devices, like remote blood pressure monitors, scales, pulse oximeters, and more, to continuously monitor vital signs and gather physiological data. With this critical data, providers can prevent escalations and better treat the illnesses and their symptoms, driving superior patient health outcomes and improved quality of life.
Hospital in The Home – also known as Hospital-at-Home
As defined by the researchers who developed the model of care, HTH was originally designed to cost-effectively treat acutely ill older adults in their own homes while improving patient safety, quality, and satisfaction. Nowadays, that definition has evolved to describe patients of all types who receive hospital-level care wherever they may live.
One important distinction from the other models of care:
HTH is limited to those who are stable enough to avoid hospitalization.
The benefits of HTH are many — for example, it can eliminate the risk of patients being exposed to infections in a hospital environment and free up beds in the hospital, all while enabling patients to enjoy the convenience and comfort of being in their own home.
RPM is helping providers meet increasing patient demand for hospital-grade care at home, and as the technologies evolve, costs are coming down, making it more affordable than ever. The simplicity of RPM devices is that they’re easy to set up, so they’re not intimidating to patients, and powerful enough to still deliver robust capabilities. This enables providers to monitor patients and oversee their care remotely while delivering just as effective treatments as they would in a hospital setting.
The value of remote patient monitoring services in care management
From transitional care to CCM and even HTH care, RPM can serve a variety of use cases and be used to help treat a diverse range of conditions. RPM services can also work in tandem as a patient transitions from one model of care to another, which can ensure a more seamless patient experience.
As a result, patients will feel connected to a more robust care ecosystem, and providers can gain even deeper insight into their condition while observing how it changes from one status to another, detecting problems early, and intervening when necessary. In the end, RPM can help make more informed care decisions and deliver superior patient health outcomes, which is the ultimate goal of any model of care.
Looking for more information about RPM or wondering how you can get started with it? Connect with a CareSimple RPM specialist today.