January 2019 marked the Centers for Medicare & Medicaid Services’ (CMS) monumental roll-out of reimbursements for Remote Patient Monitoring (RPM) enabling providers and hospital systems to receive up to $143 per patient per month. Hospitals and medical group providers are now thrilled with garnering a decent return on their investment while at the same time improving clinical care for their patients.
Unfortunately, Home Health Agencies (HHAs), which account for 50% of all RPM used in healthcare, were not subject to the new law. However, reimbursement for RPM is coming to home health soon as CMS has made payment and policy changes for HHAs that focus on the needs of patients through innovation rather than the traditional volume of visits. This includes a final rule that would eventually allow home health agencies to bill Medicare for remote patient monitoring.
Better Access to Remote Patient Monitoring
CMS’s final rule defines remote patient monitoring as “the collection of physiologic data (ECG, blood pressure, glucose monitoring, etc.) digitally stored and/or transmitted by the patient and/or caregiver to the HHA.” This definition aligns with the description of the 2019 CPT reimbursements to providers and hospital systems. With a focus on the 2020 calendar year, the new rule intends to include the costs of remote patient monitoring as an allowable administrative cost, if remote patient monitoring is used by the HHA to augment the care planning process. It also separates RPM from telehealth restrictions relating to urban locations, allowing all patients access to RPM.
The final rule explains “fluctuating or abnormal vital signs could be monitored between visits, potentially leading to quicker interventions and updates to the treatment plan creating fewer complications, reduced readmissions, and decreased costs.” It reports “remote patient monitoring may improve patients' ability to maintain independence, improving their quality of life.”
Home Health Agencies and RPM – Improved Outcomes and Lower Costs
RPM and home health agencies actually benefit each other. What telehealth does is open the doors for a more patient-centric discussion. A study in 2006 quoted by the National Institutes of Health (NIH) revealed that virtual visits by patients suffering from chronic illness can help improve the outcome for patients and also at lower costs than home healthcare visits. Yet another study revealed that HHAs can be positively impacted by telehealth and should therefore make up their care delivery model. The patient has greater autonomy with the help of improved communication and education.
Home health personnel can optimize the time they spend with patients. It improves the quality of home care referrals too. Caregivers can check on patients even when they are physically and geographically apart. Since, through RPM, caregivers regularly monitor patient health, patients can reduce unnecessary hospital or clinic visits. As a result of so many advantages of remote patient monitoring, HHAs are the largest healthcare segment employing RPM even without reimbursement for the service as of now.