Do you wish you could get your patients to be more engaged with their healthcare?
Remote patient monitoring (RPM), a method of healthcare delivery that utilizes intuitive digital technology to collect medical data from patients outside of traditional healthcare settings, is a great way to do just that.
Not only that, RPM offers clinicians yet another profitable revenue stream for their practice.
Healthcare providers can collect and track a variety of patient health data including weight, activity levels, blood pressure, heart rate, blood sugar, and more.
The data is transmitted to the healthcare provider instantaneously, allowing them to monitor their patients around the clock.
In 2018, the Centers for Medicare & Medicaid Services (CMS) began offering reimbursement to healthcare providers that provide RPM services to patients.
Since then, ThoroughCare has helped many clinicians reap the rewards RPM offers with easy-to-use, intuitive technology.
Read on to learn more about what RPM is, how it can benefit your practice and your patients, and how easy it is to get started.
What Is RPM?
As we stated, RPM enables healthcare providers to collect and track a variety of patient health data, allowing both patient and provider to monitor their health.
But how is this done?
To capture the data, RPM can employ a variety of wireless devices such as blood pressure cuffs, biosensors, glucometers, and more. These devices are used in one of two ways: either post-discharge from a hospital or in between routine office visits.
Using RPM in between routine office visits can improve the relationship between patient and provider, and keep the patient more engaged with their health.
This usually leads to healthier lifestyles and thus less frequent office visits, freeing up your clinic to care for more patients.
While utilization of these devices varies depending on the type of device, they all share the ability to transmit user-entered data, securely store that data in easily accessible systems, flag abnormal readings/responses, and provide alerts to clinicians of those abnormalities allowing for highly responsive care.
Typical care provided includes the logging and review of the information, before a follow-up or other appropriate action.
Since RPM provides clinicians with a more holistic view of a patient’s health over time, it works harmoniously with programs like Chronic Care Management (CCM) and lends itself to the implementation of a patient-centered care plan.
Think of it like this: a patient-centered care plan can be developed for any given patient, and that plan may include the patient participating in both CCM and RPM.
CCM provides a monthly check-in with the patient, while RPM supplies the provider with daily readings to monitor between the monthly CCM check-ins and less frequent office visits.
Benefits of RPM
RPM has benefits for both patients and providers.
For patients, RPM empowers them to better manage their health and become an active, engaged participant in their healthcare. For clinicians, there are numerous benefits that we’ll detail below.
By monitoring your patient’s numbers daily, you can capture a significant amount of data in real-time.
This data can be used by care managers to better monitor trends in the patient’s health and proactively address any concerns before they develop into more serious health issues.
By heading off health issues early, you can reduce the cost of treatment for both your practice and the patient.
By leveraging the data RPM provides, you can address one of the most common issues practices face: patient non-compliance.
Getting patients to take the proper steps to manage their chronic conditions can be a difficult task, especially when they may only be in contact with a care manager once a month.
While CCM provides a monthly touchpoint for patients, RPM provides a daily connection between doctor and patient.
This knowledge can get patients more invested in their own health and take ownership over managing their chronic conditions.
Adaptability of Medication
RPM tracks a wide range of physiological data that can be monitored closely to see how prescribed medications are affecting the patient.
In the past, it could have taken weeks or months for a patient to schedule a follow-up visit with a doctor to see how medication has reacted with the patient.
With RPM and CCM, practices can determine early-on if a medication is having the desired effects on a patient. This reduces costs involved with patients not taking medication properly, misdiagnosis, and repeat office visits.
Patients can go many months between office visits, decreasing revenue for your practice. On top of that, you must deal with cancellations and rescheduling, adding to both staff time and cost that your practice will bear.
RPM can offer an additional $119/month to your practice; this includes $54 for 20 minutes of RPM staff time and $65 for the provided device with daily monitoring.
CMS added the ability to bill for an additional 20 minutes per month for an extra $22.01, bringing your potential total revenue of providing RPM to $141.01 per patient per month.
Additionally, you may also bill for the initial setup and configuration of each device you give a patient, provided the devices are given to the patient in different months (see more details in the next section).
Coding and Billing Requirements
CMS made important changes to expand access to RPM, including new reimbursement rules.
Previously, providers were only allowed to be reimbursed for 20 minutes of RPM per patient, per month.
CMS now allows providers to bill for an additional 20 minutes of RPM per patient, per month (with no limit). The new billing code for the additional 20 minutes of RPM care is 99458 and will reimburse providers for $22.01.
Below is a breakdown of the RPM reimbursement structure your practice can use:
For initial setup configuration of devices: bill 99453 for a total of $21.00
For the provided device with daily monitoring: bill 99454 for a total of $65.00
For 20 minutes: bill 99457 for a total of $54.00
For anything beyond 20 minutes:bill99457 ($54.00)plus99458 ($22.01)as many times as is appropriate for additional 20-minute increments
Note: For code 99453, you may only bill that once per device. You would not be able to bill 99453 twice in one month, even if you gave the patient two devices that month.
For example, if you gave a patient a blood pressure monitor in January, you may bill 99453 for January. If you then gave the patient a digital scale in February, you may then bill 99453 for February.
Note: Code 99454 may only be billed once, no matter how many devices the patient is using.
If you have a new RPM patient utilizing one RPM device, and you have provided 40 minutes of care to the patient over their first month, you would bill all four codes listed above, reimbursing you a total of $162.01.
Moving forward, if you only provide 20 minutes of RPM care per month for the patient, you bill 99457 for the 20 minutes plus99454 for the provided RPM device and monitoring, for a total reimbursement of $119.00.
How Do I Get Started?
While implementing an RPM program isn’t a monumental task, you will want to be sure you do your due diligence to set yourself up for success.
In starting your own RPM program, you’ll first want to be sure it’s addressing a need:
Do you have patients that can benefit from RPM?
Does it align with the goals of your practice?
To ensure smooth implementation, you’ll want to have a structured plan in place. When creating this plan, ask yourself questions such as:
Who will manage and educate the patients?
Who will manage the devices?
Who will monitor the data?
Who will handle the coding and billing?
One of the biggest barriers to success for RPM programs is patient engagement. It can be difficult for patients to become active participants, especially for older patients who may be more adverse to technology.
This is where selecting who will manage and educate your patients becomes critical.
Your selected staff will essentially be serving as teachers, motivating patients and teaching them the skills, knowledge, and mindset they need to reach their health goals.
Because staff and care managers play a crucial, time-consuming role in managing RPM patients, having an intuitive software to improve efficiencies can be a godsend.
We know shopping for care management software can be a burden. Providers want to know what the benefits are, what features to look for, and how to choose the right options.