The implementation and reimbursement of remote patient monitoring is a transformative development in the field of healthcare. Although the vigorous adoption during the Covid-19 pandemic reflected the needs of the time, remote patient monitoring has many benefits and can have a significant impact in improving clinical practice workload, chronic disease management, and patient experience.
in a Recent webinars Sponsored by 100Plus, The health technology and medical technology company provided a roadmap on how its plan works, including equipment deployment, collaboration with clinicians to evaluate patient eligibility, and implementation and reimbursement.
Dr. Mintu Turakhia is a cardiac electrophysiologist, results researcher, clinical trialist, and head of medical consultation at 100Plus. He provided some background knowledge on the difference between the chronic disease management of the CMS program and the recently adopted remote patient monitoring.
The CPT code 99457 is a monthly billing code for remote patient monitoring, which is used to compensate providers for the direct cost of remote monitoring of physiological data when treating patients. To qualify for reimbursement, clinicians and other healthcare professionals must provide at least 20 minutes of interactive patient care each calendar month. 100Plus promotes interactive remote care through its patient clinician portal, bridging the gap between visits by using consistent patient data, making remote patient monitoring easy and accessible.
Turakhia shared the results of a clinical study conducted by the University of Pittsburgh Medical Center on patients with type 2 diabetes who participated in a remote patient monitoring program with connected blood glucose meters. Participants successfully reduced H1C levels.
He also highlighted a 100Plus study, which involved 14,309 patients with medical insurance—42% of men and 58% of women. First-line results include a significant drop in blood pressure and weight loss in patients with hypertension within 180 days.
Turakhia also shared his view that although asynchronous care will continue to exist, remote patient monitoring may change over time as it will adapt to the needs of practice and the development of government programs.
Mike Wurm, Director of Product and Strategy at 100Plus, outlined how 100Plus helped its RPM program practice. He pointed out that unlike many RPM programs that use Bluetooth, it chooses to use SMS text/cellular data because it does not require configuration, because almost everyone has a mobile phone that provides SMS text messages. Wurm also pointed out that 100Plus can help determine which patients in the doctor’s practice are eligible for RPM insurance.
The patient receives a device that can transmit cellular data. These devices can include blood pressure cuffs, digital scales, blood glucose monitors, pulse oximeters, and digital thermometers. It also plans to add a spirometer.
Patients interact with a participating platform called Ava. Artificial intelligence-based virtual medical assistants will prompt patients to use their devices to transfer physiological data. The goal of the CMS RPM plan is to provide a richer time series of clinical parameters, and doctors can provide better preventive care based on these parameters to reduce reactive care, such as hospitalization and emergency visits.
Nadia Ziyadeh-Hammad, RPM coordinator at Greenville Healthcare Associates, which uses 100Plus, points out that the large screen and fonts on the device make it easier for elderly patients to use.
She also talked about how an elderly patient who did not like to see a doctor agreed to remote monitoring and got help from the platform. Physiological data transmitted from the male patient’s device indicated that he had experienced some tachycardia events. When Nadia’s team followed up with the patient, he reported fatigue and chest pressure. They asked him to come in for an electrocardiogram, and the data showed that the patient was close to a cardiac event.
Although RPM has been launched for 3 to 4 years, a new variant of the program that CMS is currently piloting is remote treatment monitoring, which focuses on lung and musculoskeletal diseases.This includes Five new RTM codes, all of which are effective from January 1, 2022.
Quoting National Law Review Hypothetical examples of how the final rule will work in practice:
A rescue inhaler equipped with FDA-approved medical equipment is prescribed for asthma patients. The device can monitor when the patient uses the inhaler, the number of times the patient uses the inhaler in a day, the number of puffs/dose used by the patient each time, and the pollen count And the environmental factors that existed at the location of the patient at that time. This is non-physiological data. The treating physician then uses the data to evaluate the patient’s response to treatment and compliance with the asthma treatment plan. This allows practitioners to better determine how patients respond to specific drugs, which social or environmental factors affect the patient’s respiratory state, and what changes can be made to improve the patient’s health.
In just two years, the RPM program provided a way for the wider adoption of virtual health tools. As we stand out from the pandemic with greater comfort, using digital health tools in the care of chronically ill patients, it will be interesting to see how the CMS RPM program develops and how 100Plus responds.
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Photo: Maria Symchych-Navrotska, Getty Images
