Remote Patient Monitoring (RPM) has become an important tool for healthcare providers managing patients with chronic conditions. But a proposed change to CMS rules could significantly affect how RPM programs are structured, particularly for small and rural practices that rely on third-party care management organizations.

In a recent episode of the CareCoordinated Podcast, ThoroughCare founder and CSO Dan Godla spoke with Misti Guenther, founder and CEO of 2-G Consulting, about the potential impact of CMS's proposed 2027 changes to Remote Patient Monitoring.

The discussion focused on an important question:

How can CMS reduce fraud, waste, and abuse in RPM without making it harder for legitimate organizations to provide high-quality care?

For 2-G Consulting, which manages approximately 3,200 patients—including roughly 300 RPM patients—the answer may require finding a middle ground between increased oversight and maintaining access to care.

Important: The changes discussed in this article are based on the proposed rule. Proposed changes should not be interpreted as final CMS policy.

What Is Remote Patient Monitoring?

Remote Patient Monitoring is a form of care that allows healthcare teams to collect and review patient-generated health data outside of traditional office visits.

Depending on the patient's needs, RPM can provide information such as:

• Blood pressure
• Heart rate
• Pulse oximetry
• Weight
• Other vital measurements

According to Misti Guenther, the value of RPM extends beyond simply displaying patient data on a graph. The data can give care managers a real-time picture of how a patient is doing and help identify changes that may require follow-up.

For example, a weight increase in a patient with congestive heart failure may provide an important signal that warrants attention. Similarly, an abnormal blood pressure reading can prompt a care manager to contact the patient and communicate with the provider.

This ability to identify trends between office visits is one of the reasons RPM can complement traditional chronic care management.

What Is CMS Proposing for RPM in 2027?

The proposed CMS changes would move RPM back toward direct supervision.

As Dan Godla explained, when RPM was initially introduced in 2019, it operated under a direct-supervision framework. Over time, RPM moved toward general supervision, similar to Chronic Care Management (CCM).

The concern raised during the podcast is that returning to a more restrictive direct-supervision model could make it substantially more difficult for practices to use outside care management organizations to operate RPM programs.

Godla explained that, as discussed in the proposal, the requirement could mean that RPM care management staff would need to be direct employees of the physician practice rather than employees of an independent third-party organization.

For large health systems, that may be more manageable.

For small physician practices, however, the implications could be significant.

Why Could Direct Supervision Be Challenging for Small and Rural Practices?

Small physician practices often don't have the resources to hire dedicated RPM staff.

Guenther described working with practices ranging from two providers to eight providers. Even an eight-provider practice may not have enough RPM volume to justify hiring another full-time employee.

In her words, a practice may need something closer to a fraction of a nurse rather than another full-time position.

That creates a practical challenge.

A practice may need:

• RPM-trained staff
• Patient monitoring
• Device management
• Data review
• Patient outreach
• Provider communication
• Follow-up on abnormal readings

But hiring and maintaining that infrastructure internally can be difficult, especially for rural practices with limited staffing and financial resources.

The cost of RPM devices can also become a barrier when practices are unable to purchase devices in bulk.

Guenther said some of the rural and smaller practices her organization works with may simply stop offering RPM if they are required to build the entire program internally.

That could leave patients without access to a service they currently depend on.

The Potential Impact on Rural Healthcare

The issue may be particularly important for rural healthcare organizations.

2-G Consulting was founded in rural South Texas after Guenther and her husband, Ben, saw primary care physicians struggling to manage increasingly complex patients. The organization began with CCM and RPM and has grown from zero patients to approximately 3,200 patients over five years.

Guenther emphasized that the organization has intentionally prioritized quality over simply accepting every opportunity for growth.

That distinction is important to the broader RPM discussion.

The concern isn't whether CMS should address fraud and abuse.

Both speakers agree that preventing fraud, waste, and abuse is necessary.

The concern is whether rules designed to address bad actors could unintentionally make it more difficult for organizations that are already providing legitimate, high-quality RPM services to continue operating.

The Challenge of Balancing Fraud Prevention With Patient Access

One of the central themes of the discussion was finding the right balance.

CMS has a legitimate interest in ensuring that RPM services are being delivered appropriately and that Medicare isn't paying for fraudulent or unnecessary services.

At the same time, overly restrictive requirements could potentially reduce access to RPM for patients whose providers don't have the staffing or resources to operate these programs independently.

Guenther described seeing situations where devices from unrelated companies were sent to patients' homes, creating confusion around who was actually providing care. She contrasted those situations with organizations that have established relationships with physicians and actively monitor patients.

Her argument is that there should be a way to distinguish legitimate RPM organizations from organizations engaging in inappropriate practices.

Could RPM Certification or Registration Be an Alternative?

One potential solution discussed during the podcast was creating a certification or registration process for legitimate RPM organizations.

Under this approach, organizations providing RPM could potentially demonstrate that they meet defined quality, compliance, and operational standards.

The idea is relatively straightforward:

If an RPM organization can demonstrate that it is providing legitimate, high-quality care, it should have a pathway to continue providing RPM services.

Godla noted that certification and registration are already used in other areas of Medicare, suggesting that a similar approach could potentially be considered for RPM.

This could provide CMS with additional oversight without necessarily eliminating third-party RPM arrangements altogether.

Could RPM Data Be Reported Directly to CMS?

Another concept discussed was using the data generated by RPM programs to improve accountability.

For example, legitimate organizations could potentially provide patient readings or outcome information directly to CMS.

The discussion referenced the use of APIs and infrastructure for outcomes reporting as an example of how technology could potentially support greater transparency.

This raises an important possibility:

Instead of relying solely on organizational structure to determine whether an RPM program is legitimate, could CMS also evaluate the data and outcomes being generated by the program?

RPM Is More Than a Graph

Perhaps the most compelling part of the conversation was Guenther's description of what RPM means to patients.

For her team, RPM isn't simply about collecting blood pressure readings or displaying numbers on a dashboard.

It can also provide patients with reassurance that someone is paying attention.

Guenther described patients who may not have family members nearby but know that their care team is monitoring their readings. If a patient who normally checks their blood pressure every day suddenly stops, the care team can reach out and determine what happened.

In one example, a patient failed to take a normal reading. The care team attempted to contact the patient and ultimately discovered that the patient had fallen and needed assistance.

That illustrates a broader point:

RPM can create a connection between a patient and their care team that goes beyond the numbers appearing on a screen.

For some patients, knowing someone is watching their health data can provide a sense of confidence and peace of mind.

RPM Can Help Care Teams Identify Changes Between Office Visits

Traditional office visits provide snapshots of a patient's health.

RPM can provide a more continuous stream of information.

Guenther described RPM as providing "true physical data" that can show what is happening with a patient in real time, including blood pressure, heart rate, pulse oximetry, and weight.

That information can help care teams recognize changes that may otherwise go unnoticed until the patient's next appointment.

Guenther sites patients whose blood pressure had previously been difficult to manage. After medication adjustments and ongoing RPM monitoring, their blood pressure became more stable. Guenther also described patients who had previously made frequent emergency room visits related to their blood pressure.

These examples highlight one of the biggest challenges in measuring preventive care:

You can measure an event that happened, but it is much harder to measure an event that never happened.

The Challenge of Measuring "Near Misses"

One of Guenther's strongest concerns was the difficulty of demonstrating the value of interventions that prevent an adverse event.

If a care manager identifies an abnormal blood pressure reading, contacts the patient, helps coordinate a medication adjustment, and the patient's condition improves, there may never be a hospitalization to document.

That's a success—but it's a success defined by something that didn't happen.

Guenther referred to these situations as "near misses" that can be difficult to demonstrate to Medicare.

This creates a challenge for policymakers evaluating the value of RPM.

A program may prevent a crisis without generating a dramatic claim, hospitalization, or emergency department visit.

From the patient's perspective, however, preventing that event may be the most important outcome of all.

How CCM and RPM Can Work Together

Another important point from the discussion was the relationship between CCM and RPM.

Guenther explained that 2-G uses ThoroughCare to allow its care managers to work across both programs.

Rather than operating CCM and RPM in completely separate silos, care managers can have a more comprehensive view of the patient.

ThoroughCare's alerts notify care managers when a patient has an abnormal reading or fails to submit a reading.

This allows the care manager to prioritize attention instead of manually reviewing every patient record.

When an alert occurs, the care manager can investigate the reading, contact the patient when appropriate, and communicate with the provider.

When there isn't an alert, the care manager knows the patient is continuing along the expected path.

This type of workflow can help CCM and RPM complement each other rather than functioning as disconnected programs.

Keeping the Provider Directly Involved Without Eliminating Third-Party Care

Another potential solution discussed was maintaining a strong connection between third-party care management organizations and the physician's practice.

Guenther suggested that an RPM organization could potentially be required to communicate directly with the physician through the practice's EHR.

In this model, the care manager wouldn't necessarily need to be a direct employee of the physician practice, but the organization would still have a direct communication channel with the provider.

For example, when a care manager receives an abnormal RPM alert, the information could be communicated directly to the physician through the EHR.

This approach could help address CMS's desire for tighter physician-care manager coordination without necessarily requiring every small practice to hire its own RPM staff.

As Guenther emphasized during the discussion, "it doesn't have to be all or none."

What Happens If the Proposed RPM Changes Become Final?

The conversation also addressed what organizations like 2-G Consulting may do if the proposed changes ultimately take effect.

Potential contingency strategies discussed included expanding CCM, having physician-office employees participate more directly, covering some device costs, and other approaches designed to prevent patients from losing access to monitoring.

The underlying message was clear:

The goal is to avoid simply removing RPM from patients who benefit from it.

For organizations serving rural and underserved populations, losing RPM could mean losing access to a level of monitoring that a small physician practice may not be able to provide independently.

What Could the Future of RPM Look Like?

The discussion between Godla and Guenther ultimately came back to compromise.

Guenther's message to CMS was not that there should be no additional oversight.

Instead, she argued that there should be a middle ground between doing nothing about fraud and imposing requirements that could make legitimate RPM programs difficult to operate.

Potential approaches discussed in the podcast include:

1. RPM certification or registration for legitimate organizations.
2. Outcome reporting that gives CMS greater visibility into RPM results.
3. Direct EHR communication between RPM care managers and physicians.
4. Clearer requirements for legitimate third-party RPM organizations.
5. Oversight mechanisms focused on identifying fraudulent activity rather than eliminating third-party care models altogether.

What Healthcare Providers Should Take Away

For practices currently operating or considering a Remote Patient Monitoring program, the biggest takeaway is that the regulatory environment deserves close attention.

The proposed changes discussed in the podcast could have implications for:

• Rural primary care practices
• Small physician groups
• Third-party RPM organizations
• Care management companies
• CCM and RPM workflows
• RPM staffing models
• Patient access to remote monitoring

At the same time, the conversation demonstrates why RPM continues to be an important component of chronic disease management.

When implemented appropriately, RPM can provide care teams with timely patient data, create opportunities for intervention, support communication between patients and providers, and give patients confidence that someone is paying attention to their health.

For organizations like 2-G Consulting, the priority remains quality.

The company has grown from zero patients to approximately 3,200 while intentionally limiting growth when necessary to maintain the quality of its care.

The Future of Remote Patient Monitoring May Depend on Finding the Middle Ground

CMS has an important responsibility to protect Medicare from fraud, waste, and abuse.

Healthcare organizations also have an equally important responsibility to ensure that legitimate patients continue receiving effective care.

The debate surrounding the proposed 2027 RPM changes highlights the tension between those two goals.

The question may not be whether RPM needs oversight.

Instead, the more important question may be:

How can CMS strengthen RPM oversight while preserving access to high-quality remote care?

For rural and small physician practices, the answer could determine whether they can continue offering RPM at all.

And for patients who depend on their care teams to monitor their health between office visits, the stakes could be even higher.

As Guenther's message to CMS emphasized, the solution doesn't necessarily have to be a choice between unrestricted RPM and eliminating third-party care.

There may be a middle ground that protects Medicare while allowing legitimate RPM programs to continue helping patients.

Learn More About Remote Patient Monitoring

ThoroughCare is a leading care management software platform that provides technology designed to help healthcare organizations manage care management programs, including CCM and RPM, within connected clinical workflows.

To learn more about how technology can help your organization build, manage, and scale a Remote Patient Monitoring program, explore ThoroughCare's care coordination solutions.

Full Podcast Transcript: CMS 2027 RPM Proposal and the Future of Remote Patient Monitoring

The following transcript has been lightly edited for readability. Filler words, false starts, unnecessary repetition, and conversational interruptions have been removed while preserving the substance and meaning of the original discussion.

Introduction

Dan Godla:
Hey everyone, this is Dan. Welcome back to the CareCoordinated Podcast. On today's episode, we're talking about RPM and CMS's 2027 Final Rule Proposal with our good friend and valued partner, Misti Guenther of 2-G Consulting. Misti, thank you for joining us today.

Misti Guenther:
Thank you for having me.

Dan Godla:
Misti, can you tell our audience what 2-G does? Tell us a little bit about the services you provide and what types of patients you manage at 2-G?

Misti Guenther:
We are 2-G Consulting. We just hit five years this week.

We've been partners with ThoroughCare for five years. ThoroughCare gave us the passion and the confidence that we could do this.

My husband, Ben, and I started 2-G on a prayer and with some wonderful physicians we wanted to give back to. We knew primary care physicians were struggling in this space, so we started a CCM and RPM company here in rural South Texas.

We currently manage about 3,200 patients. When we started with ThoroughCare five years ago, we had zero. We've grown from zero to 3,200.

We care for about 300 RPM patients, which we'll get into a little more. We have an excellent group around South Texas, and we also have a group in Arizona that we've been blessed to take care of.

Dan Godla:
That's incredible that you're at 3,200 already. One thing I'll share is the quality of care that you and your team provide. It's top-notch. These patients are incredibly fortunate to receive care from your team.

Misti Guenther:
I can't take the credit for that, but I can tell you that we have great staff.

We utilize several ThoroughCare services to make sure we provide good quality. We have not accepted all of the growth that has been offered to us because we wanted to make sure the quality was there.

Quality is key to us. We want to be good partners, provide robust care to our patients, and have a strong CCM and RPM program for the providers who allow us to care for their patients.

CMS's Proposed 2027 RPM Changes

Dan Godla:
Let's get into RPM. For those who aren't familiar with some of the proposed rules, last month CMS announced a tentative proposal for 2027.

Keep in mind that this is all proposed. We don't find out if it's final until typically the first week of November, when the Final Rule comes out.

The proposals have some very interesting things, particularly around RPM this year.

One of the things CMS is trying to do is fight fraud, waste, and abuse. I think we would all agree that's a good thing. We don't want fraud in healthcare.

Unfortunately, it looks like some bad actors have caused the OIG and CMS to take notice. The restrictions being proposed may be prohibitive in trying to fight those bad actors.

What about the groups that provide quality care? Do they have to pay the price because of efforts to cut down on groups trying to cheat the system?

Misti Guenther:
It is very discouraging at times.

Here in South Texas, we have had random devices show up in patients' homes. When you're taking good care of the patient and have the appropriate device, and then suddenly your billing is blocked, you find out that it's a company from another state associated with a physician the patient has never seen and doesn't have an actual relationship with.

I can't agree more that we need to prevent fraud, waste, and abuse. But what this could do is penalize the people who are working hard to provide quality care.

For us in rural South Texas, these physicians don't have the capability to take care of these programs or do what third parties that are doing good work can do for their patients.

These bad actors keep putting people on programs and sending devices, creating abuse. I wish there were a different way than taking the program away from organizations that are trying hard to follow the letter of the law and provide good care.

Returning to Direct Supervision

Dan Godla:
Let's talk about what you mean by taking it away.

The proposal, as written, is to go back to direct supervision.

When RPM came out in 2019, the rule was defined as direct supervision, meaning you had to have a direct relationship with the provider. You could even have to be in the provider's office with them. You had to be in the same facility and very close to the provider.

Over time, it became general supervision, similar to CCM.

The advantage to general supervision is that a smaller clinic that doesn't have the means to staff an RPM program can still participate. Especially in South Texas, they may not have the resources.

Misti Guenther:
Our group in Arizona wouldn't be able to do it either because these are small practices.

Primary care physicians are taking the same hit as everybody else, with less reimbursement while having to take care of more critical and complex patients.

It's very hard to watch. We watch this happen.

Dan Godla:
Back to direct supervision: as I understand the proposal, it's not even that you have to be in the same room with the doctor. They're now saying you have to be a direct employee.

Misti Guenther:
Employee.

Dan Godla:
So you couldn't even have one of your staff members go to that clinic?

They're saying the clinic has to hire them.

I understand what they're trying to do. They want the patient, care manager, and doctor to have a tighter relationship. The care manager needs to be very close to the doctor.

But I think there are ways to accomplish that, and your team has been really good at it.

You keep your providers updated. If you're doing RPM with a blood pressure monitor and get an abnormal alert, how do you keep the provider in the loop?

Misti Guenther:
There are many different ways people do CCM and RPM.

One of the things we do is keep providers directly in the loop. I believe you should be a part of the physician's EHR so you can send messages directly to the physician. That allows you to coordinate direct care.

I don't have to be their employee, but if I can communicate directly through their EHR, that could be a regulation: You have to have the ability to maintain that connection.

There are a lot of ways to approach this.

Dan, you've been a good voice in coming up with solutions. It doesn't have to be all or nothing.

Let's come up with what's in the middle.

That's how we're able to communicate directly. We have the ability to speak to providers through their EHR. When we receive an alert telling us that there is a critical or abnormal reading, we communicate directly with the provider.

That's direct communication.

The Challenge for Small Practices

Dan Godla:
It's unfortunate that smaller clinics may not be able to afford a full-time resource. Maybe they only need a third of a nurse. How do you hire a third of a nurse?

That's where your team can come in for groups that, logistically, have difficulty getting up and running.

Then there are devices. They're not buying devices in bulk.

Misti Guenther:
They're expensive.

Dan Godla:
What would your advice be to a clinic that uses a group like yours and now hears about this proposal?

Again, it's not final.

Misti Guenther:
It's a strong proposal.

I've had several conversations with my providers.

One of my groups has eight providers. Another has two. We cater to physician groups of all sizes, but we treat them similarly because having eight providers doesn't necessarily mean they can afford to hire that additional third of a person.

The big communication has been how disappointed they would be. Without us, they wouldn't have somebody who can help, and their patients would go without that care.

They can't absorb the entire cost of the devices, and they wouldn't have the staff needed to monitor the devices the way they should be monitored.

They're basically saying they would stop doing it.

Sure, that saves CMS money if people stop doing RPM, but it's going to cost much more if these patients have hypertensive crises that we've been able to stop.

It's so hard to measure how many strokes you may have prevented because you were able to intervene during hypertensive episodes, get patients help, and adjust medications.

That's what's sad: you can't show Medicare all the near misses.

How do you show them how many patients you truly prevented from experiencing a train wreck?

The Patient Impact of RPM

Dan Godla:
These are unintended consequences that could potentially happen.

A patient who likes the service and enjoys having someone look over their numbers gets peace of mind. They feel like their care team and provider are actively watching over them.

For that to end would be a bad thing.

I hope a lot of groups submitted comments. CMS asked for them, and we submitted comments.

My hope is that there's something in the middle.

We think this proposal may be too extreme, but we can't do nothing because that wouldn't combat fraud.

One idea I like is having a quality group such as yours go through a certification or registration process.

Misti Guenther:
Sign me up.

If people are providing good care and have no reason not to demonstrate their quality, they should be able to provide RPM.

It's the organizations committing fraud, waste, and abuse that are the problem. There are many people doing a lot of good for patients.

I'm with you on that. Sign me up. I would support it.

Dan Godla:
Any legitimate company would agree to participate in that.

It's not unprecedented. Medicare has certifications and registration processes for other programs. If you're going to participate in a shared savings plan, you have to get certified.

Could it work here? Maybe.

Another idea is for groups that fake numbers. That's definitely fraud.

What if we sent blood pressure readings directly to Medicare?

Medicare has recently done something similar with the ACCESS program. It's based on outcomes reporting, and they built APIs and infrastructure to receive those outcomes.

Could there be a day when we're so confident we're getting real patient readings that we provide them directly to CMS?

Misti Guenther:
Absolutely.

Can I bring up a patient? I don't want to forget about this patient.

You mentioned that patients like the program. One thing it gives them is confidence that somebody cares about them and is monitoring them.

We live in a world filled with anxiety, depression, and mental health challenges.

For a patient who doesn't have family nearby to know that their nurse is watching to make sure they check their blood pressure each day is significant.

If they don't check it, the nurse calls to make sure they're okay.

Do you know how many patients are found because they didn't answer the phone and someone was sent to check on them, only to discover that they had fallen and couldn't check their blood pressure?

RPM is a much bigger program than just the graph.

Dan Godla:
I didn't even think of that.

Misti Guenther:
There's so much in rural health and so much we're doing for patients outside of the graph.

It's not just about the graph for the patient. It gives them peace of mind.

Think about how much that can save CMS through other programs when a patient knows somebody cares about them, monitors them, and will call 911 or someone else if they stop checking their readings.

If a patient checks their blood pressure every day and suddenly stops, you can call their emergency contact and potentially save them from lying on the floor for two or three days.

It's so much bigger.

We have patients who rely on RPM for much more than preventing a heart attack or stroke.

Those numbers can be reflected in their overall health. When people are anxious and nervous, their vital signs can be higher. Their blood pressure and heart rates can increase.

It really goes hand in hand with some of the other struggles we have in healthcare.

The program is much more valuable than just the graph and the numbers we provide to CMS.

Dan Godla:
Thank you for sharing that story. I had never thought about it that way.

That's your lifeline to these patients. It's more than just, "They took their reading today." It's, "How are they doing overall?"

That's really important.

I hope that if this were to pass this way, we aren't going to let these patients lose care.

What Happens If the Proposal Passes?

Dan Godla:
Let's say it passes. I hope it doesn't, but have you guys at 2-G thought about your contingency plans?

Could you do more CCM?

I'm trying to understand what groups are thinking.

Misti Guenther:
Hopefully it doesn't pass.

But I do hope there are better guidelines to prevent fraud so the program is less scrutinized for those of us who use it appropriately.

We have 3,200 patients, but we don't have 3,200 patients on RPM.

We're not trying to maximize every patient or give them a device for no reason.

There are companies that do those things, and there are many more patients we could provide RPM to.

We've tried to figure out how we could continue providing RPM through CCM. We've gone in every direction trying to figure out how to continue using our devices.

I live in rural South Texas. These patients may live out in the middle of a farm. They don't have landlines anymore.

The cellular devices work extremely well here and give patients peace of mind.

I can't take that peace of mind away from them.

We've been cautiously optimistic and trying to find ways to help.

We've also been looking at what costs we could absorb if that's what it takes to continue providing great service.

We've considered having an employee of the physician's office participate with us. We've considered a medical director. We've looked at every possible direction.

We're going to hope the proposal doesn't pass as written, but we have plans and ideas because I can't let it go.

I can't stop providing this to my patients.

I believe it's more than just the number. It's a lifeline to a lot of people.

Dan Godla:
You mentioned there may be a situation where you have to absorb the cost of the device.

I guarantee many other groups aren't going to go that extra mile.

That's what I like about you guys: patient quality comes first.

If you had to buy the device, maybe you could bill some additional CCM minutes, but you would still be out of pocket for the device because it provides value to the patient.

Misti Guenther:
That's why we don't have 3,200 RPM patients.

RPM would only go to patients who really need it.

I would continue to pay for the service through ThoroughCare so that I still had eyes on the patient. That's the extreme we would go to make sure we continue providing value.

Some patients would clutch the device to their chest and wouldn't want to let it go because it means so much to them.

We had a gentleman we discussed this morning. I told my team I was getting on a podcast and asked them to give me some patients who stood out in their minds.

RPM provides true physical data.

The phone calls we make to patients and everything we do through CCM are valuable enhancements to care.

But RPM provides actual data.

What else provides that real-time information without having to make contact with patients?

RPM gives you a visual picture of what your patient is doing right now: their blood pressure, heart rate, pulse oximetry, and more.

For a CHF patient, the scale can tell me what they ate for dinner. If their weight is up, maybe they had too much salt.

RPM shows you much more than CCM can at times.

My staff loves talking to patients. But with RPM, you can talk to a patient and then get an alert because their vital signs are abnormal.

That's what I mean by RPM.

We're not only an RPM company. We provide dual services, and RPM isn't always the favorite program for my care managers.

But they can see the results.

This morning, our communication channels were filled with stories.

One patient used to check his blood pressure 25 times a day. Now we're down to once or twice because he has confidence that things are going to be okay.

Another patient used to leave work after seeing a critical number, and we'd have to call him and find him because he ran a business and would take his meter to work.

It was story after story.

We were able to get medications readjusted, and now we have stable blood pressures for these patients.

We remember how many times some of them went to the ER for blood pressure problems before they started RPM.

Now they rely on us, and we're able to contact the physician and make medication changes.

When RPM is run appropriately and you truly respond to the numbers and assess the patient, it can make a significant difference.

Dan Godla:
I love it. Your team is a perfect example of how this program should be run.

They're excited to share those stories, and it makes me feel good to know that's the type of care you're providing.

Misti Guenther:
I told my team I'm getting on a podcast and can talk about this all day, so either give me the information or tell me why I shouldn't talk about it.

My team is the people doing the work.

I still take care of a few patients, but I don't get to care for them nearly as much as I used to, and that's my passion.

I have to live life through my team now.

They know how much I appreciate those stories and how much passion I hope they're providing to the patients.

How ThoroughCare Supports CCM and RPM

Dan Godla:
The one proposal we didn't talk about—sorry, I derailed us.

Misti Guenther:
My passions fly out about patients and wanting to do the right thing.

We're fortunate to have you guys as a partner.

If somebody is looking at RPM right now and the proposal does not pass and they want to do it, know that ThoroughCare gives you the tools.

Misti Guenther:
Let me say this on the podcast.

ThoroughCare gives you the tools when you're trying to manage a CCM program while also having RPM.

They're separate programs, but you can allow care managers to work across both because you have ThoroughCare.

The alerts go off when you set the parameters.

You're able to merge the programs to a certain degree and have one care manager who knows the patient inside and out work across both programs instead of running RPM in one silo and CCM in another.

You continue to enhance the tools and help us.

We call them the "bells."

I see messages all day saying, "Check your bells."

Those bells are our lifeline to the patient.

We don't have to open every chart. The bell goes off and tells us to check what the patient just did.

If there is no bell, the patient is generally continuing along and has checked their blood pressure.

The bell also tells us when somebody didn't check their blood pressure.

Thank you, because you've helped us achieve success in our RPM program, and it continues to grow.

I love seeing all the things that are coming.

Dan Godla:
I'll share this with our team, Misti. That means a lot, and I'm glad the software is working for you.

We've got a lot of good ideas to come that will hopefully make things even better.

Misti Guenther:
I've been sitting on a couple of ideas.

When we're done, I have a meeting for a pilot we'll be participating in. You guys have done all kinds of great things, and I've been able to see some future items that are coming.

I love that you get us involved.

We're one of your smaller partners. We're down here in South Texas with 3,200 patients. You have much bigger players out there.

But I value that you value our quality.

We've had opportunities to take on much larger clients. Sometimes I'm willing to give it a shot, but I've also said no because we can't sacrifice quality, and we're not made for that.

I really appreciate that.

And I want to make sure I say this before we end: ThoroughCare is an excellent software partner.

You keep us up to date and bring information to us quickly.

I follow other software companies to see what they're doing, but you guys are much faster at releasing information and features.

I can't thank you enough.

Dan Godla:
I'm blown away. Thank you.

It's a great partnership, and we get a lot out of working with your team.

Your team constantly has great ideas.

Let me give you a second to plug yourself.

You said you work with clinics in southern Texas. If there were a clinic elsewhere in the United States, do you work with groups outside your geographic area?

And if someone wanted to work with the 2-G team, how can they get in touch with you?

About 2-G Consulting

Misti Guenther:
Dan, I'm kind of hidden.

Everybody asks, "Misti, what's your website?"

Honestly, every patient and every provider we've had has come through a referral.

We don't market, although getting on a podcast is marketing.

Every opportunity we've had has come because somebody heard about what we do.

We do have a 2-G Consulting website. We created it so we could share some of the great things we've had the opportunity to do.

I believe people who want to do a good job and want a quality program know how to find us.

If they really wanted to participate with us and needed our assistance, they could ask ThoroughCare, and ThoroughCare could direct them to us.

I don't get on podcasts to put our business out there or recruit companies.

We're here when the right people come to us.

I don't want to spend our time trying to talk too much about 2-G because the right opportunities will come.

We do good work, and that comes through our work.

We only take on what we can handle.

Dan Godla:
You're so humble, Misti.

Misti's Message to CMS

Dan Godla:
Let me close with one question.

If you could say anything to CMS about the decision they have to make in the coming months, what advice would you give them?

Misti Guenther:
My biggest message is that I don't think it's a yes or a no.

I believe there is somewhere in between that could make this a successful program based on many of the situations we've discussed.

There are ways we can compromise without saying RPM can only be provided by primary care physicians.

If you do that and it goes back to primary care practices alone, the program is not going to be the same.

I believe it could cost CMS more money through additional ER visits, blood pressure crises, potential strokes, or heart attacks because you won't see those trends.

A patient showing up once every three months or every six months, depending on their chronic diseases, isn't going to provide the same level of monitoring that a successful RPM program can provide.

I believe there is something in between, and I'd love to see that.

Dan, you've made plenty of suggestions, and I believe the comments submitted to CMS contain many good ideas for preserving this program.

We need to prevent good third-party companies from losing the ability to provide care when they are potentially saving CMS money by preventing disease exacerbations.

Dan Godla:
Well said. I can't say it any better.

Ladies and gentlemen, Misti Guenther of 2-G Consulting. Thank you, Misti. I appreciate your time today.

Misti Guenther:
Thank you for letting me have a voice.

ThoroughCare is very good at letting me have a voice and improving the industry while allowing me to talk about what a good partner you can be.

I'll close with this:

It doesn't just have to be a dream. Go help these patients.

The market is wide open for CCM and RPM. There are a lot of patients who could benefit from it.

If you have the idea, or if it's something you're thinking about, and you have good morals and ethics, go talk to ThoroughCare.

They can help you get set up so you can take care of patients.

Dan Godla:
I love it. Misti, thank you so much for your time. I appreciate you.

Misti Guenther:
Thanks, Dan.

Dan Godla:
All right, everyone. That's it for today's Care Coordinated Podcast. Appreciate you joining us today. We'll see you on the next episode. Have a good day.