Fort Lauderdale, FL , July 5, 2016 (Newswire.com) – For medical professionals, the ability to work with patients remotely in their homes is an extremely effective method of prevention. Remote Patient Monitoring (“RPM”) allows the immediate capture and notification of any medical issues that a patient with a chronic condition might experience. Over 71% of the U.S. Healthcare dollar is now spent on treating patients with chronic conditions; 86% of the Medicare dollar. This is well over $1 trillion per year.
Leveraging new connected health technologies to manage the 19 or more Chronic Conditions that the Centers for Medicare and Medicaid have now identified will now be critical to shifting the cost curve as government reimbursement shifts from” volume based” reimbursement to “value based” reimbursement through the under MACRA Quality Payment Program (“QPP”), MIPS and the APMs.
Better yet, the Centers for Medicare and Medicaid are now subsidizing the cost of Remote Patient Monitoring for the home and outpatient settings under CMS Code 99490 which pays providers $41.92 per patient per month for “non-face-to-face” virtual visits using a remote patient monitoring platform. This applies to any patient with 2 or more Chronic Diseases which are expected to last 12 months or more (71% of the cost to the nearly $3 trillion U.S.healthcare system).
In addition, CMS is also paying providers approximately $163.88 and $230.86 per patient for post discharge transitional care which also involves a “virtual visit” (CMD Codes 99495, 99496) that may be performed by the physician or other qualified health care professional and/or licensed clinical staff under his or her direction. The payment amount is based on the complexity of the medical decision making (E&M 3 or 4) and how quickly there is a follow-up visit (less than 14 days or less than 7 days).
Steven R. Gerst: The success rate achieved with remote patient monitoring technology is what is moving thehealthcare industry into telemedicine today.
Several companies that are addressing this market only providing remote monitoring systems, but they are also integrating the systems and hardware into provider environments, helping them classify their patients, staffing their teams, and incorporating RPM analysis into their electronic health records. There are only a few that have the scale and infrastructure to support this as well as a large install base. This primarily includes those companies already in the home security business with millions of homes already serviced 24/7, Personal Emergency Response systems in place and a 24/7 staffed service line to handle emergencies with direct ties to 911.
The few companies that have this infrastructure are also developing direct connections from the home to both thetelemedicine companies for virtual visits and the spines of the larger Electronic Medical Record systems. This provides this provides “real-time” actionable data” for hospitals and providers to achieve the “Triple Aim” 1.significantly improve access to care; 2. Improve quality of care, and; 3. Dramatically reduce cost as the system moves to “Value Based Care and Outcomes Management.
Steven R. Gerst: Focus on the High Cost Conditions.
Remote Patient Monitoring technology is initially focusing on the high cost chronic conditions such as Congestive Heart Failure (“CHF”), Chronic Obstructive Pulmonary Disease/Asthma (“COPD”), Diabetes, and Hypertension which can easily be remotely managed by exiting FDA cleared 510K connected devices. These include 510K clearedBluetooth connected weight scales, glucometers, spirometers, thermometers, pulse oximeters and 2 lead EKG sensors.
These Bluetooth and WiFi dual band technologies can then be automatically paired to a 3G/4G hub for real-time data transmission to the physician’s EMR with alerts and alarms set based on pre-established parameters set by the physician for each patient. This customizes the remote care for each patient’s specific medical condition and needs.
This will dramatically reduce the incidence of medically unnecessary hospital 30 day readmissions for which over 2,600 were penalized by CMS last year up to 3% of the Medicare reimbursement totally over $428 million.
At the recent American Telemedicine Association meetings in Minneapolis, one company reported drastically reduced physician office visits and ER readmissions through the use of connected pulse oximeters, scales, and blood pressure cuffs on a group of 400 pulmonary obstructive disease patients.
Also being showcased at the ATA 2016 were monitoring devices and cutting edge technology that had been developed specifically to be user friendly “plug ‘n play” RPM platforms for both patients and caregivers. New monitoring technology is opening up opportunities for health IT and tech vendors which will dramatically improve lives and reduce the cost of care. These solutions are perfect for the Accountable Care Organizations, MSOs, hospitals and insurers with at-risk populations in Medicare Advantage plans, Commercial and capitated Medicaid plans.
Steven R. Gerst: Behavioral healthcare also benefitting from advancements in telemedicine.
While remote patient monitoring, telephonic chronic care management and telehealth medical consultations benefit those with chronic physical conditions, mental health consults and treatment services are also quickly being added to the list of healthcare services that providers can offer their patients remotely, according to Forbes.com.
Telehealth firms are expanding their reach to provide access to psychiatrists, psychologists and therapists via asmartphone, tablet, or computer as part of a national effort to reduce the rates of suicides, addiction, and various mental health conditions.
The introduction of “telepsychiatry” services to mental health patients will help match patients with doctors in a sector of healthcare where there is a national shortage of psychologists and psychiatrists. Telemedicine will help bridge a gap where, at present, very few dealing with mental health disorders actually receive treatment.
To learn more about the latest growth in remote health and home monitoring, visit: www.stevenrgerst.com.
Dr. Steven R. Gerst is a Managing Partner of Telemetrix Systems, LLC (firstname.lastname@example.org) and is an Entrepreneur-in-Residence at the University of Miami, Miller School of Medicine, U Innovation, Office of the Vice Provost.
Steven R. Gerst is a graduate of the Columbia University College of Physicians and Surgeons (M.D.), Columbia College (B.A.), Columbia School of Public Health – Health Administration (M.P.H.) and the Goizuetta School of Business at Emory University (M.B.A.). He is a Diplomat in the American College of Healthcare Executives. He is also Dean Emeritus of the Masters of Science Program in Applied Health Informatics at Bryan University (Los Angeles, Sacramento, Toronto and Phoenix) where he serves on the Board of Advisors and has taught on the faculty. Dr.Gerst also has recently been invited to join the faculty of the University of Miami, School of Nursing and Health Sciences and has served as an Adjunct Professor of Biomedical Informatics at Nova Southeastern University College of Osteopathic Medicine.