|
RPM is Good for Business, WISeR Companies, and Q3 Reports
November 13, 2025
|
|
|
|
|
Together with
|
|
|
|
“AI is the path to better healthcare for everyone. AI is how our society levels up, escapes an increasingly zero-sum world. It’s how we grow the economy to increase wealth broadly, and enable a higher standard of living across society. Or let me put it another way: take AI out of the picture and the gains over the next decades look much harder to come by.”
|
|
Microsoft AI CEO Mustafa Suleyman
|
|
|
|
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.
|
|
Start Getting Leads From ChatGPT and Google AI
If your healthcare company isn’t getting leads from ChatGPT and Google AI Overviews, it’s probably because your content isn’t optimized for AI search. Tely AI runs keywords and questions research, generates and publishes GEO content, and captures new leads – all on autopilot. Create your first article on us to start filling your pipeline with patients and partners from today’s lead sources.
|
|
Withings and Babyscripts Tackle Maternal Health
Babyscripts is teaming up with Withings Health Solutions to tackle the leading cause of maternal mortality in the U.S. – hypertensive disorders of pregnancy, including preeclampsia. Learn how remote patient monitoring with BPM Pro 2 is helping Babyscripts keep mothers safe through personalized support when they need it most.
|
|
- CMS Selects Six Companies for WISeR: CMS revealed the six companies that it chose to pilot its new AI-powered prior authorization program: Cohere, Genzeon, Humata, Innovaccer, Virtix, and Zyter. Each of the vendors will participate in the new WISeR model starting on January 1, which the pilot is limiting to codes for “low value” procedures like skin substitutes and electrical nerve stimulation that have high potential for fraud or waste. There’s a growing concern over WISeR enabling Medicare to use AI to deny care, which seems fair considering that the six companies are being compensated based on “a share of averted expenditures.”
- Hinge Reports Strong Q3: Hinge Health reported third quarter revenue of $154.2M, up about 53% compared to this time last year. The virtual physical therapy trailblazer raised its full-year forecast and told investors that it’s open to acquiring other companies if the right situation lines up. Hinge’s post-IPO warchest is apparently overflowing so much that it authorized a $250M share repurchase program – usually a sign that a company thinks its stock deserves to be higher than the market is giving it credit for (or a red flag that it can’t find a better way to spend it).
- Omada Hops on GLP-1 Train: Our other digital health IPO darling also reported a solid Q3, with Omada boosting revenue nearly 50% year-over-year to bring in $68M. It now has 831k members (up 53%), and is cusping profitability after narrowing its net loss to just $3M. Now that we’re done burying the lead, the biggest news from the call was that Omada is finally adding GLP-1 prescribing capabilities as a way to complement its behavior change programs. It’s pretty impressive that it held out this long.
- AI Impact on RCM: A survey from Omega Healthcare wrapped some interesting numbers around GenAI’s impact on revenue cycle management. Over half of the C-suite execs surveyed (51%) are already exploring GenAI for RCM, with top use cases including real-time eligibility/benefits verification, denials prevention, and customer support. The majority of respondents (71%) also reported that they’re planning to evolve from “transactional relationships to strategic partnerships,” with 49% interested in end-to-end RCM outsourcing to a single service provider.
- MyChart Central Roll Out: Epic has been making progress with its MyChart Central roll out, and UF Health just announced that it’s bringing the unified record hub to Florida so that patients can access their records through a single login regardless of which health system they visit. The move follows a similar statewide launch in Louisiana last month as Epic continues expanding its availability across the U.S. to ensure patients have “a consistent experience” across all of their providers.
- Vital Urgent Care: Vital officially launched Vital Urgent Care, an AI-driven platform that gives urgent care patients real-time updates, wait times, and personalized guidance – without requiring a single download or extra staff bandwidth. Built on Vital’s success in the ED setting, the platform integrates with major EHRs to automate its pings, keeping patients in the loop with a mobile-friendly interface that only requires a quick text message link to access. The end result is 60-78% adoption, Google ratings up from 2.7 to 4.0, and 25% more follow-up care within the health system.
- Amae Series B: Amae Health reeled in $35M of Series B funding to advance its AI care platform for severe mental illnesses such as schizophrenia and bipolar disorder. Unlike many chatbot-only models, Amae combines AI clinical support (unified patient profiles, treatment recommendations, symptom phenotyping) with face-to-face care through health system partnerships. It’s now looking to open its own clinics nationwide after demonstrating “striking results” with many treatment resistant mental disorders.
- Boosting Mammography Uptake: Sometimes the simplest solution is the best solution. Researchers from Singapore found that reminders sent via regular mail worked as well as more sophisticated tools in getting women overdue for mammography to attend exams. In a paper in JAMA Internal Medicine, researchers tried five different reminder strategies for 9k women aged 50 to 69, ranging from mailed reminders to reminders plus financial incentives. There was no statistically significant difference between the strategies (10.8% to 13.8%), and uptake of digital interventions like web pages was low.
- OpenEvidence Adds NCCN: OpenEvidence inked a new licensing agreement with The National Comprehensive Cancer Network. The high-flying digital health startup will make NCCN’s evidence-based oncology guidelines accessible directly through its AI clinical decision support engine alongside content from the network’s JNCCN journal. The news follows OpenEvidence’s eye-watering $200M Series C raise last month, as well as previous licensing partnerships with JAMA and NEJM.
|
|
Under the Hood of Navina’s AI
Navina’s AI engine harnesses over 600 proprietary algorithms to transform fragmented patient data into actionable clinical intelligence at the point of care. It’s shaped with the expertise of physicians to turn multiple data sources (EHR, HIE, claims, care gap files, etc.) into contextualized insights like suspected conditions or evidence for care gap closures – each linked back to the original source. Download the whitepaper to see examples of Navina’s AI in action.
|
|
Next Generation Ambient Tech and Agents
The ambient AI transformation is already sweeping across health systems, reducing administrative burdens and improving patient outcomes. So, what’s next? Tune into this on-demand session to learn how systems like Carle Health and Denver Health are leveraging Nabla to eliminate Pajama Time and build a future where agentic AI unlocks true workforce sustainability.
|
|
- 10 Strategies to Expedite Provider Credentialing: Lagging provider credentialing workflows can create a wave of unexpected care delays and financial setbacks. Sidestep these pitfalls by tuning into Medallion’s recording of 10 Key Strategies to Expedite Provider Credentialing and see how your organization can keep a well-oiled team and patient care intact through the ever-evolving changes seen in healthcare.
- Ambient ROI – New Metrics From Health Systems: While value is clear from the rapid adoption and positive clinician feedback after deployment of Abridge, discerning CMIOs, CIOs, and CFOs also require longitudinal and more precise impact measurement, including of operational and workflow processes. With a new ROI methodology, that’s what Abridge delivers for its health system partners. See how four health systems are using this new tool to measure ROI at a deeper level than ever before. Download here.
|
|
|
|
|
