By Emmet Seibels, President and Co-Founder of Verustat
According to Insider Intelligence, the number of remote patient monitoring (RPM) users in the U.S. will more than double between 2020 and 2025 to 70.6 million. Drastic changes in healthcare over the past few years have sparked a shift toward implementing new care options for patients. Still, some physicians and practices are hesitant to adopt RPM due to a lack of accessible information on the financial benefits.
Patient Engagement and Satisfaction
Beyond convenience for healthcare providers, RPM gives patients better access to the status of their health while actively managing a chronic condition or monitoring acute care treatment. Patients who are more actively involved in their care and who have physicians that are able to examine them more frequently, accurately and efficiently between in-person visits are more likely to stay with the same provider year after year.
Similarly, satisfied patients provide positive feedback through ratings and reviews. Suppose you’re practicing in a hospital or similar setting. In that case, you know that this type of response is incredibly important to retain current patients and attract new ones.
Both of these factors strengthen the patient-provider relationship and strongly contribute to patient retention and overall healthy living.
CPT Codes for Remote Patient Monitoring
We’ve made incredible strides in science, medicine and technology in the past decade, and these advancements have made it possible for physicians to monitor their patients remotely. In 2018, the Centers for Medicare & Medicaid Services (CMS) introduced CPT codes for remote physiological monitoring along with reimbursement for healthcare providers who were caring for patients with remote patient monitoring software for the first time.
CPT codes 99453, 99454, 99457 and 99458 were explicitly created for remote patient care and provide physician and practice reimbursement for the work that is being done. Being able to utilize CPT codes in this way allows you to amplify net patient and practice revenue.
While Medicare is the guidepost for determining RPM service fees each year, practices can expect to see a difference in return based on where they are located. For example, practices with 75% compliance in high reimbursement areas can expect to see approximately $110 a month per patient while practices on the other side of the scale can typically expect $75. In most RPM programs, a hospital or practice can expect its margin to be 30% to 50% of collections (after outsourced and internal costs). With a significant patient census, this can create large profit opportunities.
No matter where your practice is located, incorporating RPM into your business model allows you to increase revenue with your current set of patients and efficiently increase new patient volume.
Many hospitals and practices take risk for their patients’ healthcare costs. In February 2021’s BMJ Open (Taylor ML, Thomas EE, Snoswell CL, et al.), a study of 91 separate published journal articles found that remote patient monitoring can reduce acute care use for patients with cardiovascular disease and COPD. These conditions are huge cost drivers for risk sharing and capitated arrangements and can be mitigated with an effective remote patient monitoring program.
Consider all of your options
Financially, deciding what vendor will work best for you and your staff is one of the most important things to consider before integrating RPM into your practice. For example, Verustat’s full-service model handles everything from device delivery and set up to making calls to patients when they don’t measure to alert monitoring so that your healthcare team can focus on providing care as it’s needed between visits. To ensure that no additional time is taken away from you or your staff beyond patient care, Verustat’s care coordinators handle patient follow-up and alert you if an abnormal reading is identified.
When choosing an RPM partner, seek out options that absorb administrative issues and only pass clinical matters on to the medical team when emergent. This not only cuts down on overtime and unnecessary workload, but RPM management staff also helps patients maintain routine readings, a key to practice reimbursement.
At the forefront, the implementation of RPM will help provide an increased level of patient care and supplement health plans more than ever before. As a practice manager, hospital administrator or physician, fully understanding the fiscal benefits of RPM is crucial to ensuring that both your business and patients are supported. Beyond providing a high level of medical care, every facility has different goals. The great thing about full-service remote monitoring programs is that they help facilitate patient retention and acquisition, revenue growth and service expansion without increasing your workforce.
Emmet Seibels is the President and co-founder of Verustat. Prior to founding Verustat, Seibels co-founded and was President of SnapWorx and Verus Healthcare, where he grew the companies to over $90 MM in combined revenue in seven years before the companies were sold to ResMed’s Brightree subsidiary and Adapt Health, respectively. Prior to Verus, he founded FrontStream Payments and led the company through its formation, three acquisitions and all fundraising efforts creating a company with ~$13.5 MM in gross revenue in less than three years. Previously, Seibels was the second employee and part of the founding team at Verus Financial Management, a company that sold for $325 MM to Sage Group in 2006. Before his time with Verus, Emmet worked in investment banking at Robinson-Humphrey Company and worked for two start-up software companies.
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