Remote Patient Monitoring, Telehealth Support Value-Based Contracts



The COVID-19 pandemic has blown the doors wide open on telehealth, especially with new reimbursement parity policies. But value-based contracts can support the growing interest in remote patient monitoring and other virtual care services beyond the pandemic, according to telehealth experts at the Revenue Cycle Management Summit.

“Remote patient monitoring programs are growing,” Andrew Solomon, MPH, senior program manager at Northeast Telehealth Resource Center (NETRC) and Medical Care Development, Inc., told attendees last week. “These are the cellular- or internet-connected kits that we send to the patient’s home and collect vitals on a regular basis. I think organizations may be more likely to implement this kind of program in response to value-based care contracts and how we keep patients out of higher cost care and keep them in primary care and engaged.”

Remote patient monitoring programs can remind patients to collect their vitals, provide educational content, and even enable a video or in-person visit if needed to address vitals outside of a predetermined range, Solomon continued. The latter being especially helpful for providers responsible for quality and cost of care under value-based contracts.

These programs are being leveraged by some hospitals to help reduce expensive hospital readmissions that also carry steep financial penalties under value-based contracts, Solomon explained.

The buzz around remote patient monitoring has been growing alongside adoption of value-based contracts. But like the value-based reimbursement shift, adoption of remote patient monitoring has been slow with just 30 percent of provider respondents to a recent Insights survey saying their organization has a program. Many of the remote patient monitoring programs are still in their infancy, the survey results showed.

But more organizations are planning to leverage remote patient monitoring, according to a separate survey that found 43 percent of hospital providers believe adoption will be on par with inpatient monitoring in five years. However, according to over half (55 percent) of respondents, reimbursement will be the biggest challenge to remote patient monitoring adoption.

“A really interesting thing that happened in response to the COVID-19 pandemic is the evolution of telehealth in the home. In general, this was not a reimbursable service by Medicare or most Medicaid programs prior to the COVID-19 pandemic,” Solomon stated.

Federal and state governments have helped hospitals and other providers overcome the reimbursement barrier by allowing payment parity for a wider range of telehealth services during the pandemic. For remote patient monitoring specifically, CMS also allowed providers to deliver the services to new patients, well as established patients, and expanded coverage of the types of services furnished by remote patient monitoring programs to include acute and chronic conditions.

Shortly after, organizations tapped remote patient monitoring to address isolated COVID-19 patients and the sudden influx of patients at hospitals and clinics.

Moving beyond the pandemic though, organizations are seeing the potential for their remote patient monitoring programs by treating different populations, such as the chronically ill, those needing post-discharge rehabilitation services, and even patients who may have gone to a skilled nursing facility in lieu of a safer discharge option. Telehealth, in general, is also being tapped to fill longstanding access to care gaps with appropriate digital health literacy training, among other considerations.

Patients will also be expecting these programs to be part of the healthcare system moving forward, especially considering such high patient satisfaction rates, added Solomon’s colleague Danielle Louder, program director at NETRC and co-direction of MCD Public Health.

However, many telehealth reimbursement policies during the pandemic are slated to expire after the pandemic, once again creating a major gap in telehealth plans. A key question for after the pandemic, according to Solomon, will be: How will the industry connect telehealth programs to payment reform and reimbursement as it looks toward value-based care?

Value-based contracts can support remote patient monitoring programs and other telehealth services going forward since providers will not be tied to the transactional fee-for-service system, especially since Solomon said that it is still unclear what temporary payment waivers granted during the pandemic will become permanent.

Organizations are also already asking themselves how telehealth programs established or reinforced during the pandemic will play into their value-based contract strategies moving forward.

Reimbursement reform will be key to ensuring remote patient monitoring programs living up to their value-based care potential—improving quality and access to care while reducing total cost of care.

“In order to make sure that some of these policy changes continue permanently beyond the public health emergency, there’s pressure from Congress, from other healthcare leaders to ensure that the return on investment and the quality of the healthcare is there when it’s provided virtually, which we’ve absolutely seen for multiple decades,” Louder said. “When done appropriately, telehealth has wonderful outcomes and impacts for access in healthcare and health outcomes. But this is going to become increasingly important as we move forward.”

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