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Why CMS Should Reimburse Remote Patient Monitoring Providers

By Vera Gruessner

- The healthcare industry could sincerely benefit from further adoption of remote patient monitoring technology and telehealth solutions as a method for ensuring high-quality and value-based care. As such, the federal government will need to ensure Medicare programs properly reimburse healthcare providers for the use of remote patient monitoring and telemedicine services.

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Currently, there are various barriers standing in the way of effectively reimbursing providers on these fronts. For instance, payment parity between in-person visits and telehealth consultations is not always successful in various programs and insurers may not reimburse physicians as much as deserved when implementing remote patient monitoring technology.

A large group of organizations recently sent a letter to Senate Finance Committee Chairman Orrin G. Hatch, R-Utah, and Ranking Member Ron Wyden, D-Ore., arguing for the need to properly reimburse those working in the healthcare industry and utilizing both telemedicine services and remote patient monitoring technology.

Currently, the Medicare program established under the Centers for Medicare & Medicaid Services (CMS) has unnecessary restrictions on the use of telemedicine and remote patient monitoring services within the healthcare continuum. It essentially restricts reimbursement when it comes to using these technologies among patients with chronic medical conditions, the letter states.

These technologies, especially remote patient monitoring equipment, allows for value-based care including greater care coordination among multiple teams and improved patient engagement as well as a system in which healthcare providers can communicate and track the health of their patients more efficiently.

The letter sent to the Congress chairmen by a dozen organizations including the National Alliance on Mental Illness, the National Association of ACOs, and the American Academy of Family Physicians delivers several key objectives that illustrate the benefits of telehealth solutions and remote patient monitoring technology.

First, it is important to consider the facts including Medicare and Medicaid data that shows remote patient monitoring technology actually reduces overall healthcare costs by preventing the need for emergency room visits and reducing hospital readmission rates.

Also, there are a variety of federal programs that have pushed forward care coordination, population health management, and improved access to care. Both telemedicine and remote patient monitoring services add to these goals of better patient care and health outcomes.

“Achieving the goals of value-based care will require investment in new tools that improve patient engagement, increase care coordination, decrease inappropriate resource utilization and allow providers to monitor and communicate with patients for whom they will now be responsible for total cost and quality of care,” the letter stated. “Connected care technologies like telemedicine and remote patient monitoring are an investment that will help actualize the vision embedded in these transformative programs and deliver on the promise of value over volume in health care.”

As the entire country moves forward with healthcare reforms meant to improve the quality of care while reducing healthcare costs including unnecessary spending, it is hoped that Congress will consider properly reimbursing healthcare providers for utilizing life-saving technologies and effective communication systems.

“We ask that Congress create a transition mechanism by which the Secretary of Health and Human Services may lift originating site restrictions, and allow payment for remote monitoring of beneficiaries suffering from chronic diseases,” the representatives stated in the letter.

“We believe these reforms should remain in effect until at least the year 2021 as a bridge for providers who have committed to changing their practices to comply with MACRA [Medicare Access and CHIP Reauthorization Act] or for ACOs working to achieve risk-based models. Such a transition period would facilitate preparation and serve as a glide path to a new era of value-based care.”

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