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Providers Urged to Wait on Remote Patient Monitoring

A Chilmark report says the connected care ecosystem is still being driven by payers, and it expects most health systems won't be fully invested in mHealth until the end of the decade.

By Eric Wicklund

- A new analysis of the connected health ecosystem advises healthcare providers to take a “wait and see approach” on mHealth devices and platforms.

“Migration to Connected Health: Opportunities & Challenges in Remote Patient Monitoring,” prepared by Chilmark Research, lists a number of provider organizations that have seen financial and clinical success in using connected health platforms. Yet the report says the payer market, still managing much of the risk in the market, is driving adoption, and most providers are reluctant to jump on board.

“Looking at the connected health market today, it appears the shift to provider-dominated purchasing (of connected health tools and platforms) is still a couple of years away,” the report notes. “Outside of the small pack of large provider systems innovating, the average health system or small hospital will simply wait until there is a better reimbursement climate.”

Still, the potential is quite evident: “Though we are in the early days of this market, connected health holds tremendous potential for everyone involved: For health system executives tasked with bending the cost curve, for nurses and doctors charged with caring for a highly complex patient population, and especially for patients and their loved ones tasked with figuring out an illness they may not understand or be able to manage on their own,” the 31-page report concludes.

The report calls the idea of using mHealth to manage entire populations “science fiction given where technology and the market are today.” Health systems will only adopt connected care technologies when they start accepting large, value-based contracts and target the high-risk patients who represent the biggest source of healthcare costs.

On a separate level, Chilmark sees more progressive health systems, self-insured employers and health plans to lead the way in adopting connected care platforms to manage chronic conditions such as diabetes, asthma and hypertension.

The report cites four conditions that point to increased provider adoption of mHealth by the end of this decade:

  1. The transition to value-based reimbursement by Medicare and private payers;
  2. Stage 3 of the Meaningful Use program, which calls on health systems to begin collected patient-generated data in 2018 – a mandate that will compel providers and EHR vendors alike to invest in connected care models;
  3. Medicare’s reimbursement for remote management of chronic care (CCM), a program that’s seen by many in the industry as the first, tentative step toward reimbursement of remote patient monitoring;
  4. And the ongoing trend of states updating their Medicaid reimbursement models to cover remote patient monitoring.

While advising health systems to be patient on the market, the report also urges them to begin due diligence.

“While Chilmark Research is optimistic on the potential of connected health models, we are also realistic as to the tremendous amount of work and the high costs that can go into virtually monitoring a population,” the report said. “Data governance is an example of a key area in which there is no existing blueprint – many provider organizations will require hand-holding during this early stage of maturity.”

Couple with that reticence is an understanding that the mHealth market is improving quickly.

“(W)hile it may take a few more years for the reimbursement environment to open up to a point where these models are more pervasive, the industry is evolving at a rapid pace,” the report concludes. “Devices are becoming smaller, more efficient, less invasive and more affordable every year. The power of algorithmic analysis of data - machine learning, and even self-regulating medical devices – is no longer around the corner; these innovations are being refined and commercialized by industry titans today. What these models will look like, what they will cost, and how well they will work just five years from now is unknowable.”


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