Building a Remote Patient Monitoring Program to Improve Care Quality and Ensure Financial Sustainability for Hospice Providers

by | Jun 18, 2020 | Blog

Over the next decade, the average age of the US population will increase significantly. It is estimated that one in every five residents will be age 65 or older by 2030. With that comes rising costs from caring for chronic conditions as older individuals tend to have multiple and more complex comorbidities. An estimated 80% of all healthcare expenditures are related to treating chronic conditions. In addition to costs, caring for our elders takes up between 40% to 50% of all healthcare resources.

The projected growth in this population should serve as a wakeup call, especially for hospice providers who may already be challenged with trying to do more with less. Organizations that have yet to implement an integrated remote patient monitoring (RPM) strategy would be wise to take action now to prevent any further revenue erosion.

Enhanced care management

In the past, most remote monitoring was conducted over the phone. The effectiveness of this method was only as good as the patient’s memory and willingness to share information at the time. For example, it can be challenging for hospice patients at home to remember if they’ve taken medications, which ones they’ve taken, or whether they’ve had medications refilled. Providers have no way of really knowing. According to an article in Today’s Geriatric Medicine, medication nonadherence is among the top ten leading causes of death in the US.

Providers can remove much of this ambiguity through remote devices that can capture and relay real-time health information from the patient’s home or hospice location. Elevated blood sugar over a period of days can indicate a patient needs an insulin dosage adjustment. High blood pressure measurements may mean that patients are skipping medication because they have no way to get to the pharmacy for a refill. Having this information allows clinicians to take quick action to help avoid deteriorating conditions, hospitalizations, or worse.

Telehealth as part of the equation

Once considered a nice-to-have, the COVID-19 pandemic has thrust telehealth into the forefront, making it the go-to option for providing care to patients while social distancing. Having the ability to talk face-to-face with a patient creates a more intimate, trusting relationship between the provider and the patient. It also allows the provider to better assess and triage patients to the most appropriate care—something that is more challenging via a phone call alone. Telehealth appointments also cut down on the number of in-person visits needed, which reduces drive time and allows providers to spend more time with each patient or to see more patients without adding resources.

RPM and telehealth effectively extend care beyond the exam room. Hospice patients don’t need to wait for their next appointment to have an urgent need addressed.

Increased reimbursement

In November 2019, the Centers for Medicare and Medicaid Services (CMS) issued its final proposed rules for services covered under the Medicare Physician Fee Schedule for 2020, which includes provisions for RPM. To encourage adoption, the CMS has created four new CPT codes for RPM and CCM (chronic care management). The CMS has also increased reimbursement for telehealth to support social distancing guidelines for the pandemic. These changes represent significant new revenue opportunities for providers. Even though there’s no guarantee that the telehealth adjustments will continue once the pandemic has faded, efforts are underway to make telehealth a more financially viable option ongoing.

In addition to increased revenue, RPM and telehealth improve patient outcomes and enhance patient satisfaction—both of which further improve potential income.

A new approach

If helping hospice patients live the healthiest, most fulfilling lives possible is the ultimate goal, then we must use every tool currently available to make that goal a reality—especially as the growing need for hospice services explodes over the next ten years. With new reimbursement opportunities, there’s no longer a reason to resist implementing an RPM or telehealth program. And there’s never been a better time to act than now. In addition to improving quality care, patient satisfaction, and your bottom line, an integrated RPM and telehealth strategy helps ensure long-term financial viability.

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