Using Remote Patient Monitoring to Increase Practice Revenue Without Bringing on New Patients

Remote Patient Monitoring (RPM) may be one of the best defenses against the stubborn challenges of medical inflation. Other names for this rapidly-growing patient care intervention are:  Remote Physiologic Monitoring and Remote Therapeutic Monitoring. In this article, the Medek RPM Patient Care Team  will describe how this technology can help to improve patient outcomes as well as practice revenues. 

The High Cost of Excellent Patient Care

The costs of running a successful medical practice have been rising steeply in recent decades. Like any other business, a medical practice is subject to inflationary pressures. The year-over-year US inflation rate is currently at an astounding rate of 8.4%.¹ This has a major effect on healthcare providers and their patients.

The COVID-19 pandemic, labor shortages, supply-chain disruptions, and other economic predicaments² have levied immense financial strain on healthcare providers as they work tirelessly to provide high quality, cost-effective patient care.  In order to compensate for significant labor shortages, particularly in the healthcare fields, medical practices are offering significantly higher wages to attract skilled employees.³ Payment structures of insurance carriers are unpredictable and convoluted, making financial solvency especially difficult for those in private practice.⁴

Boosting Revenues While Tackling Medical Inflation

Oftentimes, administrators in medical practices have the impression that the only way to increase revenue is to take on more patients. Particularly for physicians in small-to-medium private practices, this would mean longer hours as well as increases in supporting staff for tasks such as billing and office management. Revenues from increased patient load might be largely canceled out by the increased costs of running a business.

The Centers for Medicare and Medicaid Services (CMS), recognizes the value of connected technology interventions, such as Remote Physiologic Monitoring. Thus, they have designated a series of CPT codes that cover patients throughout the continuum of care.^5,6

CPT Code 99453 – Initial set-up and patient education

⇒Physicians are reimbursed simply for starting an RPM service. Initial patient education is provided by the Medek Patient Care Team.

CPT Code 99454 – Data recording and programmed alerts

⇒Each day that patients use these connected devices, biometrics such as weight, blood glucose, pulse oximetry, and blood pressure are transferred seamlessly to the designated providers. This includes alerts that need special medical attention.

CPT Code 99457 – 20 minutes per calendar month (cumulative) on patient care management

⇒This reimbursement does not require a patient visit. Interactions with patients can be completed by other providers besides physicians.

CPT Code 99458 – Subsequent 20-minute blocks of time beyond the initial 20 minutes

⇒Covers additional time for patient care, which helps to ensure that patients remain as healthy as possible.

Case Example

If a physician sees a patient once per quarter for diabetes management at a cost of $100 per office visit, this would mean $400 per year for the medical practice. The allowable Medicare reimbursements for Remote Patient Monitoring/Remote Physiologic Monitoring may total as much as $180 per month in addition to revenue from inpatient visits.

ADDITIONAL RESOURCE: Get an estimated monthly revenue for your Medicare patients who receive RPM

Medical Conditions Treated with RPM

In its Final Policy Fact Sheet, CMS clarified that RPM may be medically necessary for acute as well as chronic conditions.⁷ Here are just a few examples of diagnoses that can be treated with RPM:

• Hypertension and other cardiovascular conditions
• Diabetes
• Obesity
• Weight loss
• Chronic obstructive pulmonary disease (COPD)
• Cerebral-Vascular Accident (CVA)
• Hyperlipidemia^8,9
    

ADDITIONAL RESOURCE: Using Remote Patient Monitoring for COVID-19

The Major Positive Impact on Rural Healthcare¹⁰

RPM is an essential strategy in our nation’s rural communities. A large rural hospital system found that 87% of enrolled patients had no emergency room visits. Joseph Bianco, MD, a family practice physician in rural Minnesota strongly supports RPM as an alternative to hospitalization:

“Hospitals are not always safe places for patients, especially older adults who are frail. But these patients also might not be safe if they are sent home, … Remote Patient Monitoring program allows providers to notice subtle changes in a patient’s vitals or behavior and intervene before the patient’s condition worsens.”[para. 6,7]¹¹

RPM, therefore, is not only helpful for revenue, but also is a key factor in illness prevention and keeping patients out of hospitals.

The Big Picture

Navigating through the “perfect storm” of medical inflation, COVID-19, and staff shortages is a strain for private practice providers and large healthcare systems alike.

The Deloitte Center for Health Solutions, an international healthcare research and consulting firm, sees all types of virtual care as a catalyst for financial solvency and positive patient outcomes. RPM tools maximize virtual check-ins, adding value to the entire patient experience.^12,13 

Getting Started with Remote Physiological Monitoring

Even though the Medek onboarding process is comprehensive, it’s fast and easy with these 5 steps:

1. Schedule a demo.
2. Sign on with no initial costs or risks.
3. Identify patients who would benefit from RPM (or let Medek do the work for you).
4. Medek specialists begin the billing process.
5. Start earning additional revenue without increasing patient loads.

The best part of our process? There are no up-front costs for you or your patients.

At Medek, we invite you to partner with a highly-skilled group of  healthcare professionals for your financial health as a business and for the long-term health of your patients. 

Contact Us Today to Learn More About Medek’s Full Service Remote Patient Monitoring Program

Sources

1. Amadeo, K. (2022, October 13). What is the current US inflation rate? The Balance. https://www.thebalancemoney.com/current-u-s-inflation-rate-statistics-and-news-3306139
2. Burrill, S., Gerhardt, W., Arora, A. (2020). Hospital revenue trends: Outpatient, home, virtual, and other care settings are becoming more common. Deloitte Insights. https://www2.deloitte.com/us/en/insights/industry/health-care/outpatient-virtual-health-care-trends.html.
3. (Author). (2022, February 14). Inflation In Medicine and What Future Holds For Doctors. https://investingdoc.com/inflation-in-medicine-and-what-future-holds-for-doctors/#:~:text=As%20I%E2%80%99ve%20said%20in%20another%20post%2C%20inflation%20of,past%20year%20inflation%20%282021%29%20of%207%25%20per%20year
4. Arana, N. (2022, March 29). Top 5 way medical practices can combat inflation. AdvancedMD. https://www.advancedmd.com/blog/top-5-way-medical-practices-can-combat-inflation/.
5. Centers for Medicare and Medicaid Services. (2020, December 1). Final Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2021. https://www.cms.gov/newsroom/fact-sheets/final-policy-payment-and-quality-provisions-changes-medicare-physician-fee-schedule-calendar-year-1
6. Lacktman, N.M., Ferrante, T.B., Goodman, R.B. (2020, December 7) 2021 Medicare Remote Patient Monitoring FAQs: CMS Issues Final Rule. Foley and Lardner, LLP. https://www.foley.com/en/insights/publications/2020/12/2021-remote-patient-monitoring-cms-final-rule.
7. Centers for Medicare and Medicaid Services. (2020, December 1). Final Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2021. https://www.cms.gov/newsroom/fact-sheets/final-policy-payment-and-quality-provisions-changes-medicare-physician-fee-schedule-calendar-year-1
8. Health Resources and Services Administration (n.d.) Leveraging remote patient monitoring in your practice. https://th-site-downloads.s3.us-east-2.amazonaws.com/Leveraging+Remote+Patient+Monitoring+In+Your+Practice.pdf.
9. Medek RPM. (n.d.) Frequently Asked Questions. https://medekrpm.com/faq#hfaq-post-2343.
10. Mead, A. (2021, July 14). Remote patient monitoring helps rural patients recover at home. Rural Health Information Hub. https://www.ruralhealthinfo.org/rural-monitor/remote-patient-monitoring/.
11. Ibid. [paragraphs 6 and 7]
12. Burrill, S., Gerhardt, W., Arora, A. (2020). Hospital revenue trends: Outpatient, home, virtual, and other care settings are becoming more common. Deloitte Insights. https://www2.deloitte.com/us/en/insights/industry/health-care/outpatient-virtual-health-care-trends.html.
13. PwC Health Research Institute (2021). Medical cost trend: Behind the numbers, 2022. [Chart Pack]. https://www.pwc.com/us/en/industries/health-industries/library/assets/pwc-hri-behind-the-numbers-2022.pdf

Additional Source – MedekRPM Website