There is a revolutionary way of delivering care to patients by using real-time data to ascertain a patient’s health status. These data points are then electronically transmitted to a clinician, which may require immediate intervention and thereby prevent a problem from escalating. This is what Remote Patient Monitoring or RPM is all about. It delivers care wherever the patient may be and the most likely and safe place during a public health emergency is at home. It is virtual care that is on-time, on-point, and accessible at any time or place.
What is remote patient monitoring?
RPM is a reimbursable telehealth program introduced towards those with – or at the chance of developing – a chronic condition. For example, if a patient has hypertension, a provider might deliver a Cellular blood pressure cuff and request the patient to bring a daily measure. An RPM software platform (like 1bios) will automatically collect the measures, make alerts and mail messages, deliver monitoring dashboards for a monitoring team, follow the time spent studying the data, and optionally merge to a provider EHR.
Operating RPM is like sending a virtual nurse home with your patient to maintain an unflinching eye on vital health data. The monitoring devices are your eyes and ears, sending routine reports back to mission control.
All parties – patients, providers and payers – can help from an RPM agenda. Patients are decreasing their risk of hospitalization and long-term health costs while enhancing their health status with the help of a technology-enabled “still on” care team. Providers can provide enhanced virtual care, and grow their virtual care revenues while enticing and retaining patients. Payers decrease the total cost of care by controlling hospitalizations, and adverse acute health events (like heart attacks), and can enhance or stabilize their comprehensive health status.
Financial Considerations of a Remote Patient Monitoring Program
Let’s begin with the basics. The first query you need to answer is, do you have patients that can benefit from RPM? Of course, the patient benefits. At least 20% – 100% of your patients have one or more of the following diagnoses:
- Hypertension
- Diabetes
- Obesity
- COPD
- Heart Disease
These conditions impact the most people and can be monitored easily by using the most cost-effective and easy-to-use monitoring devices in 2022. These devices are affordable, easy to use, and accurately provide the measurements you can utilise to monitor and help patients improve their health.
Once you know patients would benefit from an RPM program, you’ll need to provide you can finance your RPM program. The most popular method is via payer reimbursement. CMS/Medicare began to reimburse for the current RPM model in January of 2020. Large commercial national payers (United Healthcare, Humana, etc.) also reimburse at equivalent levels to Medicare. Twenty-two (and counting) Medicaid programs also offer reimbursements. A successful RPM program will reimburse between $100 – $200 Per Patient Per Month (PPPM) for CPT Codes 99453, 99454, 99457, and 99458.
Reimbursement is not the only budget approach. Controlling hospital readmission, concierge care bundles, and cash pay (patient out-of-pocket) can also function. The funding will help you cover the three primary costs of an RPM program: software (i.e. The RPM Platform), hardware (i.e. The Monitoring Devices), and people (i.e. Monitoring/Care Team).
RPM Delivers Quantifiable Benefits
RPM is a method of healthcare delivery that harnesses the power of telecommunications technologies to monitor and collect patients’ health data outside of traditional settings. The benefits are immense and can be summed up as a win-all for patients and providers alike.
Revisiting a previous blog entitled Is Remote Patient Monitoring Important To Your Practice?, RPM is preventive care at its best with positive impacts on patient health outcomes, cost reductions, and patient engagement. It brings much-needed care to Medicare patients with chronic conditions so that they can live a quality life and avoid the cost of complications or hospitalizations.
RPM bridges the care gap by extending its reach even to the remotest populations. It creates opportunities for effective communications, fosters trust, extends continued support, and builds a closer relationship between a clinician and their patients.
It is also a very lucrative Medicare program with billable reimbursements for a new revenue stream. More than the incentives, RPM brings to a practice a competitive edge and transforms workflows for increased efficiency and productivity.
With such quantifiable benefits that RPM brings to a practice, it is only right that your next question should be, when can I start?
At the same time, understand that starting your own RPM program will likely involve substantial investments of time, energy, and money on your part, so it’s not for the faint of heart. With different vendors and models out there to choose from and each one promoting their brand, finding out which one would be a perfect fit for your practice can be daunting. Therefore the next question would be, with whom should I start?
Knowing What Fits Your Practice
As RPM continues to evolve and grow with the encouragement and support of the Center for Medicare and Medicaid Services (CMS) one of the ways to differentiate between various vendors is to identify what makes one program better than another.
In getting started with RPM, here is what a comprehensive RPM program should offer:
No upfront costs, risk-free
The RPM vendor will demonstrate how to use the devices for free with no demand for a credit card or any alternative modes of payment. They will also provide the devices at no cost to the patients.
Medicare eligibility checks
Not all patients are eligible for RPM so the vendor should be willing to first check your patient population. They should coordinate with the practice to contact only the patients that are qualified to join the program.
White-Glove set up
Setup should include patient outreach, education, and enrollment. Once the eligible patients have been identified and the patients have given their consent, the vendor can now start sending fully functioning RPM devices and provide the training on their proper use.
Fully configured, ready to use RPM devices
The devices should be ready to use right out of the box with no complex instructions in setting them up. It must have integrated cellular capabilities to safely and swiftly transmit the data without connecting to wifi, plugging in the device, or requiring any manual input.
Automatic transmission of data without user intervention
The RPM vendor should use devices that automatically transmit data without user intervention so that clinicians may stay constantly informed. In this way, patients can focus more on taking the needed measurements without worrying about sending them.
Predictive Population Health management (PHM)
Transmitting the data is just a simple part of the process but what is crucial is monitoring data so the measurements do not cross preset thresholds. This includes PHM alerts the clinical team to prevent emergencies and to prioritize those who are most at risk.
Use of AI
Not many vendors now employ artificial intelligence, but this is the future of healthcare and essential in optimizing your patient care as well as efficiently running your practice. The AI virtual assistants can alert the user when measurements are not taken, taking the burden off of the clinical team so that they can better serve their patients.
EHR Integration
Integrating RPM into the EHR systems is essential in care management, but it is also required in making Medicare claims. If the EHR platform has limited storage capabilities, there is also the issue of managing security. The RPM vendor should have applications that can be seamlessly integrated into practice workflows to assure there will be no disruption to current routines.
Data Security and Patient Privacy
Leveraging a cloud-based solution that offers robust security while maintaining Health Insurance Portability and Accountability Act (HIPAA) compliance is also key to a successful RPM program.
Customized scaling for every practice
The RPM vendor should be able to rapidly scale up or down depending on the needs of a particular practice. What is important is for the vendor to be equipped to meet your needs like onboarding your patient population quickly so those who need monitoring can immediately benefit from the RPM program. The ability to scale your patients is vital because it will enable your practice to grow and generate new revenues.
To answer the question assumed earlier, you should start your RPM journey with a vendor who will offer the most comprehensive, supportive, and thorough program. It also helps if they understand your practice workflows, know the intricacies of CMS requirements, have sufficient customer support, and employ a sound technology infrastructure to implement an effective RPM solution.
Why Outsourcing RPM Is A Smart Move
If you want to capitalize on the benefits that RPM delivers, make the smart move of looking for the right vendor. Starting your own program is, yes, doable, but is it sustainable? Setting up an RPM program on your own is an incredibly tough venture and here’s why:
Additional Cost
You will have to purchase the devices, equipment, software, and other needed infrastructure. There is also the matter of training your staff with the new program, hiring new clinical staff to monitor and contact patients, bringing in the right IT resources, or and setting up the infrastructure for your own call center.
Additional Administrative Duties
Overseeing a complex program would further burden your staff with additional responsibilities on top of their already heavy workloads. There is no room for error in RPM because it could impact health outcomes and lost revenue.
Disruptions to Practice Workflows
It is inevitable there will be disruptions in your workflows as you try to navigate new technology. This could exact a toll on your productivity and the overall operations of your practice.
Understanding Medicare’s Rules and Requirements
One must be highly adept at CMS rules and keeping up with requirements particularly in the reimbursement codes to file successful claims. Otherwise, the potential to grow your revenues will be all for naught.
Getting Started with the Right RPM Vendor
Learning a new technology can be difficult and intimidating. However, the right RPM vendor can make it simple and easy. Now that you know the criteria of what a good RPM program should be, you can provide the best remote care to your patients and increase your cash flow as well.
Ascent Care Partners completes the checklist with its turnkey RPM solution. We will do all the heavy lifting so you can do what you do best: care for your patients. Talk to us or start a chat and you can get started right away.
