Remote patient monitoring (RPM) is experiencing a significant increase in adoption and securing its permanency within our evolving healthcare system. Ideal for patients who need close monitoring of their ongoing health concerns, RPM is playing an essential role in keeping patients healthier for longer and avoiding the acute exacerbations that can land them in the emergency room or urgent care.
Remote patient monitoring is a simple and cost-effective solution that can be used to care for patients with chronic diseases like diabetes, obesity, heart disease and hypertension, asthma, and chronic obstructive pulmonary disease (COPD). With its versatility and cost-effectiveness, it was only a matter of time before RPM would cross over into a wider variety of specialty healthcare arenas. This is why it comes as no surprise that remote patient monitoring is now finding a place in the practice of maternal health/obstetrics to help support pregnant women who have been diagnosed with gestational hypertension and/or gestational diabetes.
The Complexities of Pregnancy Care Today
Worldwide, the rates of maternal morbidity and mortality have improved drastically over the last century, but here in the United States, unfortunately, our rates have worsened. The American healthcare system contains many social determinants of health barriers to care for the average person, but pregnant women experience even more obstacles. Lack of insurance, transportation, time constraints, and dwindling numbers of obstetric practitioners are just a few of the issues keeping pregnant women from receiving the critical, early prenatal care they need to better ensure a healthy pregnancy and baby.
While the practice of obstetrics will never have a shortage of patients, there is a very real shortage of practitioners who choose to specialize in this area of care — one that is expected to grow going forward. Riddled with high malpractice premiums, worsening maternal/fetal health outcomes, and changing federal and state laws, obstetrics has become a field of practice that many new practitioners avoid.
But for those who pursue a career in OB-GYN, solutions like remote patient monitoring are helping improve quality of patient care and maternal outcomes. Let's look at how RPM enables maternal health practitioners to better support their patients with gestational hypertension and gestational diabetes.
Remote Blood Pressure Monitoring for Gestational Hypertension
High blood pressure in pregnancy is common in the United States, and according to the Centers for Disease Control and Prevention (CDC), 1 in every 12 to 17 pregnancies among women ages 20 to 44 is complicated by rising blood pressure numbers, leading to high-risk pregnancies. Hypertension in pregnancy can lead to dangerous complications for mother and baby, including preeclampsia, eclampsia, stroke, and preterm delivery.
Controlling climbing blood pressure numbers is vital to keeping mother and baby safe and healthy, but the tedious frequency in which blood pressure should be monitored during pregnancy and post-delivery can become an obstacle for many pregnant women and their practitioners. For pregnant women who work or have other responsibilities, the increased frequency of office visits and the need for tedious tracking and reporting of blood pressure numbers can become a barrier in maintaining the level of care needed and place both mom and baby in jeopardy.
Fran Ayalasomayajula, founder of Research for Equitable Antenatal Care and Health (REACH), identified blood pressure monitoring as one of the best tools we have to help manage hypertension in pregnancy. Since not all women show outward signs in climbing blood pressure, it's crucial for close remote blood pressure monitoring throughout the third trimester, and sometimes beyond.
The good news is that not only does highly accurate remote blood pressure monitoring technology already exists, but it is easy for patients to use and provides maternal health practitioners with real-time patient data that is actionable, secure, and authenticated. It's not surprising that the use of remote blood pressure monitoring often contributes to increased patient satisfaction.
Remote Pregnancy Monitoring for Gestational Diabetes
Per the CDC, between 5% to 9% of pregnant women in the United States will develop gestational diabetes during their pregnancy, with the trend increasing in recent years. The most effective way of mitigating the effects of gestational diabetes on mother and baby is through frequent and close monitoring of blood glucose levels, nutritional tracking, exercise, and, if warranted, medication and/or insulin injections. If not effectively controlled, high blood sugar numbers can be very dangerous for mother and baby and lead to high-risk pregnancies. As risk rises, so does the potential for an abnormally large baby, shoulder dystocia or other birth injuries for baby, the need for a cesarean birth, preterm labor, high blood pressure and preeclampsia, macrosomia, premature birth, and even stillbirth.
For expectant moms with gestational diabetes, the diagnosis means extra, more frequent prenatal care visits with a nutritionist and their obstetrician, making pregnancy more cumbersome and time consuming. Pregnant women who work, live rurally, or lack insurance coverage can find that receiving this extra in-person care is difficult and expensive. This may cause them to not adhere as closely to their treatment plan as they should, which can lead to high-risk pregnancies and harm maternal outcomes. Remote patient monitoring can reduce the effects of these barriers, making the extra care easier for pregnant patients and their healthcare team while improving neonatal outcomes.
Reimbursement for Maternal Health Remote Patient Monitoring
Obstetric remote patient monitoring provides substantial value for pregnant patients. It's also very valuable for practitioners.
From a clinical and operations perspective, RPM empowers practitioners and their staff to improve and streamline engagement with patients; better manage conditions; gain timelier and deeper insight into patient health; and expand access and care capacity with reduced administrative overhead.
From a financial perspective, remote pregnancy monitoring can deliver a worthwhile return on investment. A growing number of commercial payers are covering remote patient monitoring, with some payers, like EmblemHealth, announcing expanded coverage for maternal care RPM during and following pregnancy in recent years. RPM is also covered by more than two-thirds of all state Medicaid programs, according to the Center for Connected Health Policy.
What obstetric practitioners can expect to be paid for pregnancy remote patient monitoring services will vary by commercial payer or state (for Medicaid patients). We can look at what Medicare pays on average for RPM in 2024 to get a rough idea of what reimbursement may look like.
Medicare pays about $19 for initial patient enrollment into an remote patient monitoring program. This reimbursement covers RPM device setup and the delivering of patient education on using the device and receiving RPM services.
Medicare provides a base monthly payment of about $46 for monitoring data transmitted from a patient's RPM device and any ongoing management of the device.
Medicare then provides a monthly payment of about $48 for at least 20 minutes of communication with the patient about their transmitted data and any changes to the care management plan.
Medicare will provide an additional monthly payment of about $38 if communication exceeds 40 minutes but is fewer than 60 minutes. If communication requires 60 or more minutes, Medicare will provide a final monthly payment of $38.
A practice will typically furnish about 20 minutes of RPM care management each month to a single patient, which brings the total monthly reimbursement to around $94 per patient. The maximum monthly Medicare reimbursement a single RPM patient can earn a practice is up to around $170.
Finding Much-Needed Help With Remote Patient Monitoring
Developing a maternal care remote patient monitoring program for pregnant patients who have been diagnosed with gestational hypertension and/or gestational diabetes can help practitioners and patients alike. As we discussed, obstetrics is a busy medical field with dwindling numbers of new practitioners. The result is obstetric practices are generally experiencing a never-ending flow of patients who require regular and frequent care. Busy obstetric practitioners are constantly pulled between office visits and hospital deliveries, making it more difficult to maintain regular schedules. The ability to remotely monitor patients with gestational hypertension or diabetes by using RPM technology will free up crucial time for practitioners and help them share the burden of care with their qualified staff.
Remote patient monitoring can also help reduce access barriers to care for pregnant women, making adherence to recommended treatment regimens easier and more effective. These contribute to improved neonatal outcomes and increases in patient satisfaction and engagement in care. Remote pregnancy monitoring also helps better meet the needs of rural patients.
Since RPM technology uses smart devices that collect and transmit data over a cellular or Wi-Fi network directly to the healthcare team, the tedious tracking of blood pressure readings and blood sugar numbers can be sent to their practitioner in real time, helping eliminate errors and patient omissions. Even better, those readings can be received immediately by the healthcare team, making it easier to identify and react to concerning trends quicker, thus resulting in fewer emergency situations and adverse outcomes.
If RPM device readings indicate a concerning trend, practices can quickly engage with these patients to discuss their situation and the steps these pregnant patients should take. If a face-to-face interaction is needed to help better understand the situation, a virtual visit may help eliminate the need for a long-distance trip to receive unnecessary in-person care.
RPM as a Difference-Maker for Pregnant Women
Remote patient monitoring is already a gamechanger for an array of patients with chronic diseases, making their care more effective in quality and cost. Now we are seeing RPM crossing over into other areas of specialty healthcare and being leveraged in new ways, like pregnancy. With strong buy in from practitioners, patients, and payers, RPM is here to stay and can help your practice achieve better health outcomes for your patients.
To learn how Prevounce makes it simple to launch and scale a maternal health remote patient monitoring program, book a consultation with one of our RPM experts today!
