PMD Healthcare Blog

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PMD Healthcare Blog

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PRIVATE INSURANCE PROVIDERS FOLLOW MEDICARE IN REIMBURSEMENT FOR REMOTE PATIENT MONITORING

Recent changes by the Centers for Medicare and Medicaid Services (CMS) have led the way to an extremely promising future of remote patient monitoring (RPM). RPM uses cutting edge technology to monitor the vital signs and other important health symptoms of patients while they are at home. New codes implemented by CMS have approved substantial reimbursement for RPM. Physicians and patients alike are thrilled with the $143 monthly reimbursement per patient.

In the past, federal support has been a major barrier in the effort to bring RPM to the patients who need it most. New laws are rapidly breaking these barriers. With the roll-out of the CMS reimbursements came predictions that Medicaid and private commercial insurance would follow suit. These predictions are proving true as states like Arizona and Virginia have recently passed laws requiring all state Medicaid and commercial insurance companies to cover RPM.  Furthermore, there are approximately 90 bills currently before State legislature’s addressing telehealth and remote patient monitoring reimbursement throughout the US.

Commercial Payers Follow CMS’s Lead

The Centers for Medicare and Medicaid Services (CMS) have added new codes to change the way physicians are reimbursed for RPM. These codes offer reimbursement for set up, data review, and equipment costs. The Medicare expansion is already setting a valuable example.

Last week, The State of Virginia’s House and Senate unanimously passed legislation requiring Virginia payers, including Medicaid to fully reimburse healthcare providers for RPM services. Additionally, Arizona’s lawmakers have redefined their telemedicine policies to include Remote Patient Monitoring and crippled restrictive barriers relating to location and payer coverage. The bill was unanimously passed on February 12th by the Senate Health and Human Services Committee.

There is no denying the useful information the new expansions will provide. As Medicare and other organizations provide reimbursement for RPM, more evidence can be gathered to support the success of RPM treatment. As private insurance providers examine the increase in quality healthcare combined with monumental savings, RPM will likely become mainstream treatment across the country.

Patients Are the Real Winners

It is no secret that the healthcare systems across the country are overburdened and patients are falling through the cracks. The growing elderly population, patients with chronic conditions, and low-income households often find it impossible to meet the standards of quality healthcare when multiple trips to doctors and specialists are necessary.

Remote Patient Monitoring shows great promise in changing those standards. Studies by the Veterans Health Association has shown how RPM helps manage chronic conditions and avoid hospital readmission. Data released in 2015 from Banner Health showed a 45 percent decrease in unnecessary hospitalizations and 30 percent reduction in related costs. As the usage of RPM expands to other areas of practice, patients can experience better, more affordable healthcare.

If you are interested in the use of RPM for healthcare facilities or home use, contact us for more information. For more exciting news about the success of RPM and how it is changing healthcare, check out the articles on our website.