An Ounce of Prevention
MACs Back Off Plans to Pursue RPM and RTM Local Coverage DeterminationRead More →
Two Medicare administrative contractors (MACs) that co-hosted a multi-jurisdictional meeting to discuss efficacy of remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) have announced they will not pursue a local coverage determination (LCD) on RPM and RTM for non-implantable devices.
One of the more substantial, recent developments in the way healthcare is delivered in the United States concerns remote patient monitoring (RPM), also referred to as remote physiologic monitoring. RPM has technically been around since the early 1970s (with its roots dating back to the 19th century!), but it's been thrown into the spotlight over the past few years thanks to the pandemic and is now experiencing rapid adoption. That comes as no surprise considering the significant and wide-spread benefits of remote patient monitoring.
MultipleMedicare administrative contractors (MACs) recently held a virtual, multi-jurisdictional meeting to discuss efficacy of remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM). The meeting lasted two-plus hours and included commentary from more than 50 subject matter experts, mostly physicians from various specialties who have experience with RPM and RTM.
One of the silver linings of the COVID-19 pandemic was 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 rapidly changing as providers increasingly adopt the service and enroll 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 definition of RPM and contrasts the concept of remote patient monitoring with other terms frequently associated with it.
Over the past several years, the stars have aligned for remote patient monitoring (RPM). An overhaul of the RPM CPT codes (99453, 99454, 99457, and 99458) made RPM into a lucrative Medicare management program. Medicare is making it easier for organizations to provide RPM services, and private-payer coverage of RPM is growing. The COVID-19 pandemic helped drive the adoption and use of remote patient monitoring devices in healthcare. Finally, a rapidly growing number of patients are interested in virtual care services like RPM, their interest largely fueled by the public health emergency. These factors and others make it an optimal time to consider launching or growing RPM programs — especially when RPM is included in a more comprehensive care management program. Another motivating factor for organizations is they now have many choices of remote patient monitoring medical devices to offer patients and include in their programs. From these options, organizations can select the devices that will best meet the short- and long-term care needs of their patients and maximize RPM programs’ revenue potential.
Over the last few years, remote patient monitoring (RPM), also referred to as remote physiologic monitoring, became one of the more lucrative Medicare care management programs. Using average 2023 RPM reimbursement rates, if 100 patients are enrolled in an RPM program and each receives the minimum care management services each month, that will generate annual reimbursement exceeding $115,000. We can largely thank the overhaul of RPM CPT codes in 2020 for such generous reimbursement.
It's no secret that technology has vastly improved healthcare. In just the past few years, we've seen telehealth essentially transform the delivery of care. From increased access and improved patient outcomes to reductions in care costs, telehealth technology like remote patient monitoring (RPM) is driving healthcare evolution, helping practitioners improve the ways in which we interact with patients every day. Thanks to the ingenuity and creativity of technology thought leaders and innovators, we can now reach more people than ever before, including previously difficult to access rural patients, and do so more effectively and efficiently.
Arthritis is probably one of the most bothersome health issues patients face. Classified as both degenerative and chronic, arthritis not only produces pain, but it can also increase symptoms of anxiety and depression, impact independence, contribute to sleep problems, and lead to a host of other chronic health issues due to neglectful self-management of the disorder. Fortunately, those with the two most common types of arthritis — osteoarthritis and rheumatoid arthritis — are eligible for participation in both chronic care management (CCM) and remote patient monitoring (RPM) services. These services can be quality-of-life difference-makers for those with osteoarthritis and rheumatoid arthritis. With the wraparound care provided via the CCM and RPM care models, arthritis patients will receive the connected support they need to better manage symptoms and slow disease progression. Specifically, participation in these types of programs will help patients improve their self-management and coping skills. This can lead to decreased pain and physical harm, helping arthritis patients maintain — or even increase — activity levels and better preserve their independent lifestyle.
Natural disasters are rarely expected but should be planned and practiced for regularly by everyone. In the medical world, being ready for a natural disaster means so much more than maintaining adequate staffing and supplies. It also means being able to connect with patients at a time when they may need you the most.
Thea Blystone, PharmD, is a clinical pharmacist at Meadville (Pa.) Medical Center, which implemented a remote patient monitoring (RPM) program supported by the Prevounce platform. Dr. Blystone was one of the leaders of this project. She spoke with Prevounce about a range of topics, including why she's such a strong proponent of RPM, results of the program, why RPM is a perfect fit for rural organizations, and the evolving role of pharmacists in rural hospitals. Note: Responses have been edited slightly for clarity.