Remote patient monitoring was in the crosshairs last week after UnitedHealthcare axed its coverage, but a well-timed study in Health Affairs suggests that the cuts are bad news for practices – and their patients.
Practice makes perfect. Although many studies have looked into how RPM affects patients, this might be the first study to quantify its impact on practices themselves.
- Researchers at Columbia analyzed Medicare data from 754 primary care practices that adopted RPM between 2019 and 2021, then tracked outcomes through 2023.
20%. That’s how much the practices that adopted RPM increased Medicare revenue compared to similar practices that didn’t adopt it.
- Most of that growth came directly from RPM billing, but a quarter of it stemmed from more outpatient visits and care management services.
- It’s worth noting that the RPM practices also saw a 2.7% uptick in provider headcount, but the authors pointed out that most of the revenue gains came from higher activity per clinician rather than the additional hiring.
Patients also came out on top. Despite concerns that RPM can take provider time and attention away from patients that don’t need it, the RPM practices also ended up seeing more patients overall.
- Many of these patients had higher disease burdens or were dual-eligibles, which seems to indicate that RPM didn’t shift resources away from in-person visits.
Where does that get us? The authors concluded with a “cautious optimism” for RPM’s role in primary care, but warned that unchecked expansion could drive up costs.
- They called for thoughtful reimbursement policies with evidence-based limits on monitoring duration and patient eligibility, pretty much echoing PHTI’s recent recommendations on the same topic.
- PHTI agreed that RPM for use cases like hypertension can be very effective, but found that 40% of beneficiaries receiving RPM for blood pressure control are monitored longer than six months – well beyond what’s clinically effective.
- That might be good for the bad actors seeking revenue above-all-else, but it’s horrible for Medicare, taxpayers, and the public perception of RPM.
The Takeaway
One bad apple doesn’t spoil the whole bunch, and just because there are bad actors in RPM, doesn’t mean we should throw it all away.
