Medicare’s Chronic Care Management (CCM) program looked like a big opportunity for primary care physicians when it was launched in 2015. The Centers for Medicare & Medicaid Services (CMS) offered to pay practices about $40 per patient per month (now $45) for between-visit management of Medicare patients with two or more chronic conditions. But relatively few primary care practices have taken on CCM, partly because meeting the expansive requirements of CCM appeared quite difficult, and most groups have not been able to justify hiring extra nurses or outside services to perform the care management interactions.
Medical practices that want to keep their patients healthier while also tapping into this new revenue stream are looking for ways to make CCM more efficient and less costly—which is where mobile-enabled remote patient monitoring (mRPM) comes in. This type of technology, which typically includes a dashboard for the physician practice and a patient-friendly mobile app for check-ins between appointments, can greatly enhance communication between providers and patients. In addition, patients become more aware and engaged in their own care without overburdening the practices.
This technology enables consistent patient monitoring between face-to-face appointments—a key CCM requirement. Further, it is more efficient and cost-effective than phone-based monitoring, where only one patient can be contacted at a time and data must be recorded by a team member rather than automatically.
Remote monitoring is an expanding element of modern care. CMS recently unbundled another level of remote patient monitoring, using a different CPT code, unrelated to CCM, allowing providers to bill separately for these broader services. CMS also increased the weighting of remote monitoring as a practice improvement option under the Merit-based Incentive Payment System (MIPS). So there are plenty of reimbursement opportunities to use mobile monitoring in a primary care practice.
Will Boomers use the technology?
Physicians may be skeptical about their Medicare patients using a mobile app to help manage their chronic conditions. But there is evidence that seniors are increasingly taking advantage of mobile technology in their everyday lives, whether for texting, Facebook-sharing, FitBit-tracking, or other purposes. According to a 2017 Pew survey, 42 percent of people who are 65 years or older now have smartphones—with higher usage among more affluent and more educated seniors. Sixty-seven percent of seniors use the internet, and 34 percent use social media.
Based on the Pew survey, it’s safe to assume that many of the two-thirds of Medicare patients who suffer from chronic conditions also use smartphones or other mobile devices. That means practices can leverage mobile monitoring to track these patients’ chronic conditions at regular intervals.
This approach taps into consumers’ embrace of mobile technology as an integral part of their lifestyles. Patients want healthcare that is easy and that they can access from wherever they are when it’s convenient for them. Whether the patients are Medicare beneficiaries or others covered by value-based contracts, this technology has the potential to help primary care practices improve patient satisfaction, reduce readmissions, and improve outcomes while generating new revenue.
How the technology works
Mobile remote patient monitoring is convenient for both physicians and patients and uses few resources to reach a large population and gather their data consistently and efficiently. An automated schedule uses push notifications to prompt the patient to send in specific information at a time and place convenient for them. Once the data has been received, a clinician assesses the information and, if necessary, escalates to a face-to-face visit or phone conversation. So, from the viewpoint of meeting the CMS requirements, mobile-enabled monitoring is more cost effective and more likely to meet patients’ needs than other communication methods.
The technology typically includes some type of biometric data collection—weight, body temperature, respiratory measures, sleep quality, glucose readings, and/or blood pressure—that can be transmitted to the patient’s physician and automatically analyzed for concerns. This process can be done automatically: the information can be directly entered by the patient and shared with the care team via mobile technology.