An Ounce of Prevention
Little good has come out of the COVID-19 pandemic, but there are some silver linings. One is the increased adoption of virtual healthcare services and delivery systems. This includes remote patient monitoring, or RPM. Remote patient monitoring was a concept foreign to most individuals before the health crisis, but that is slowly changing as providers increasingly adopt the service and order it for their patients. Yet many people still lack a firm understanding of remote patient monitoring, so we thought it would be helpful to dedicate a blog that focuses on the RPM definition, including providing an RPM meaning in medical terms and contrasting the concept of remote patient monitoring with other terms often associated with it.
Over the past decade, remote patient monitoring, or RPM, has been slowly gaining momentum. 2020 was already expected to be a big year for RPM, but “big year” turned out to be an understatement. The COVID-19 pandemic has spurred RPM into the spotlight, positioning it to become an essential health-care delivery service, embraced by providers, payers, and patients. Even with all the publicity, there has been a bit of confusion about what types of care fall into RPM. Depending on the article you read, “Remote patient monitoring” can be used as a general term, a CPT coded service, or as a term of art. We wrote this fact sheet to help clarify things for both providers and patients alike.
Healthcare providers have found themselves under immense pressure to maintain continuity of care during the COVID-19 crisis, but many aspects of the U.S. health system were not designed to support such an effort. To help providers more effectively deliver care that will not only keep patients healthy but also in their homes and away from hospitals, which are largely focused on treating COVID-19 patients, government agencies, commercial payers, and other healthcare organizations have worked to change the system. Approaches taken include the creation of new and expansion of existing telehealth and remote tools and support, including remote patient monitoring (RPM). For example, we have seen federal waivers and revised state regulations that greatly expand the ability for healthcare providers to deliver telehealth and remote services; commercial payers revising their policies to pay for these services, and healthcare companies offering resources to help providers more effectively leverage telehealth and remote services during the crisis. If your practice is considering launching or growing an existing telehealth and/or remote services program during the pandemic, here are five things you should know.
Los Angeles, CA – May 4, 2020 – Prevounce Health, creators of the Prevounce Care Coordination Platform, announced today the release of its powerful new Remote Patient Monitoring software and connected patient device program.
The annual wellness visit (AWV) is an important tool for providers to track and help manage the health and wellbeing of their Medicare patients. Social distancing is crucial to combat our current health crisis, but so is maintaining continuity of care with your most vulnerable patients. Fortunately, Medicare understands the importance of the AWV, and included it in it's initial §1135 waiver so that it can be performed entirely via telehealth on any Medicare beneficiary. As of 4/30/20, Medicare further waived restrictions, and now allows Annual Wellness Visits to be conducted via audio-only telehealth (i.e. over the telephone) for the duration of the waiver.
Updated: 10/13/2020: US Health and Human Services have extended the health emergency to January 21, 2020. The Centers for Medicare & Medicaid Services (CMS) has announced a significant, temporary broadening of telehealth services coverage.
When you conduct an online search for information about the Medicare annual wellness visit or AWV, one of the first resources you will find is an independent reference tool called Medicare Interactive. Its description of the AWV is as follows: "The annual wellness visit (AWV) is a yearly appointment with your primary care provider (PCP) to create or update a personalized prevention plan." Going by this definition, one might believe that the answer to the question "Who can perform the Medicare annual wellness visit?" is a PCP. End of story, right? Far from it.
An essential element of the Medicare annual wellness visit (AWV) is the personalized prevention plan, sometimes referred to as the personalized prevention plan of service or PPPS. During the annual wellness visit, you are expected to create or update the patient's Medicare personalized prevention plan. This requirement is clearly stated, both in the regulations and AWV HCPCS codes descriptors, and yet it is often neglected. When the PPPS is overlooked, the potential ramifications are significant. Providers run the risk of experiencing claims denials, needing to return payments if shortcomings are discovered during audits, and reducing the value of the AWV and PPPS to patients.
When you think of a pharmacist, you probably visualize the person in the lab coat behind the counter at your local pharmacy. Pharmacists are always there, ready to fill our prescriptions with precision, accuracy, and counsel us on adhering to our prescribed medication therapies. But could a pharmacist also be the Medicare annual wellness visit's (AWV's) — and the time-strapped provider's — superhero incognito?
Anyone who works with Medicare on a regular basis understands how often the Centers for Medicare & Medicaid Services (CMS) seemingly changes its rules. Keeping up with new and ever-evolving policies can be challenging, but there are a few simple ways to stay current. Look for updates quarterly on the CMS website and follow the Prevounce blog for important and timely coverage of Medicare topics, especially those that matter the most to you, your practice, and your patients.