An Ounce of Prevention
Update: The 2022 Physician Fee Schedule final rule has delivered a significant increase in reimbursement for some chronic care management services and finalized the addition of new CCM CPT codes. To learn more about the substantial changes to CCM, watch our webinar covering some of the final rule's most significant telehealth and care management developments. Tucked deep within the 2022 Medicare Physician Fee Schedule proposed rule, presumably where it would be easy to miss, the Centers for Medicare & Medicaid Services (CMS) has penned a love letter to chronic care management.
Telehealth has emerged as a viable and valuable delivery care model, with remote patient monitoring (RPM) as one of the most effective forms of virtual care. While not technically a new concept, RPM has been around since the late 1960s. Since then, it has expanded and morphed into the useful solution and service it is today while gaining acceptance from practitioners, patients, payers, and the federal government.
More than 6 million adults in the United States have congestive heart failure (CHF), according to the most recent data from the Centers for Disease Control and Prevention, with heart failure costing the nation more than $30 billion annually. Both figures are expected to rise in the coming years, fueled by the “silver tsunami” of aging baby boomers, unhealthy lifestyles taking their toll, and chronic medical conditions like obesity, high blood pressure, and diabetes raising the risk of developing CHF. Since CHF is so prevalent, it's more important than ever to find effective treatment solutions that won't break the bank for patients and that help provide better control over our national healthcare spending. Enter remote patient monitoring for congestive heart failure.
There are currently dozens of telehealth bills in Congress. As is the case with most pieces of federal legislation, a majority of these bills will go nowhere. However, some have the potential to become law and significantly reshape or at least affect the rules concerning the delivery and coverage of telehealth services.
Update: The 2022 Medicare Physician Fee Schedule (PFS) final rule further defined remote therapeutic monitoring (RTM), including finalizing five RTM CPT general medicine codes, but left many questions unanswered while also limiting coverage for these codes. You can learn more about the current state of RTM in this Physicians Practice column discussing the 2022 final rule written by Prevounce Co-Founder Daniel Tashnek.We anticipate receiving more information and clarification concerning RTM in the 2023 PFS proposed and final rules. * * * The Centers for Medicare & Medicaid Services (CMS) has issued its 2022 Medicare Physician Fee Schedule proposed rule. Within it are some potentially significant developments concerning remote therapeutic monitoring, which we will discuss below.
For practitioners, getting a patient to adhere to a realistic treatment plan is probably one of the toughest aspects of delivering healthcare. The old proverb "You can lead a horse to water, but you can't make it drink" speaks volumes about how patients often behave and interact with treatment plans designed to mitigate the effects of their chronic diseases.
Over just the past few years, the usage and application of telehealth services have begun to grow tremendously, fueled largely by the pandemic.
When COVID-19 hit, it hit hard — mentally, physically, and financially. The initial impact left by the virus was far reaching, wreaking havoc on the health and financial wellness of nearly every American. Among healthcare providers, one of the groups that took a big hit early on was primary care providers (PCPs). COVID-19 risk, fear, and uncertainty contributed to the lockdowns that directly impacted PCPs' bottom lines and productivity. They were forced to postpone what were deemed unnecessary patient visits, including the Medicare annual wellness visit (AWV), and scramble to piece together creative pathways for safe, socially distanced care that could also generate enough of a continuous stream of incoming revenue to keep practices afloat amid the pandemic's storm.
Prevounce Health, creators of the Prevounce Care Coordination Platform, announces a call for entries for its annual Preventive Health Scholarship Program.
A broad, bipartisan group of 50 senators recently reintroduced the CONNECT for Health Act for a fourth time, and there is an expectation that this massive telehealth bill could become law. The bill was first introduced in 2016 and is generally considered the most comprehensive telehealth legislation in Congress. The latest version is officially known as the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021.