Reduce Administrative Burdens with Remote Patient Monitoring
A rise in telehealth visits – and in patients who want to take advantage of different types of telehealth – was fueled by the COVID-19 pandemic. But although the pandemic has officially ended, the volume of patients choosing to use telehealth services has not.
As more insurance providers begin offering telehealth visits post-pandemic, more patients are asking for these services. And that is prompting many providers, hospitals, and health systems to outsource remote patient monitoring to improve care – and outcomes – and reduce their administrative burden.
Remote patient monitoring: What it is and who can benefit
Remote patient monitoring (RPM) is a type of telehealth. According to Health and Human Services (HHS), RPM gives providers a new way to manage acute and chronic conditions while also cutting down on their patients’ risk of infection and travel costs.
This is a huge benefit for patients in rural areas who have difficulty traveling long distances to see their providers and for those in urban areas with transportation challenges, but there are other benefits as well.
Big benefits of remote patient monitoring
Let’s cut to the chase. RPM can help both clinicians and patients in many ways, and it is an important part of preventive care. For example, it can help patients by:
- Reducing ED visits by 68%[1]
- Cutting hospitalizations by 35%[2]
- Helping reduce medication noncompliance, which is responsible for half of all treatment failures and a fourth of all hospitalizations[3]
- Helping reduce physician visits by 47% and phone calls by 41%[4]
And all of that can add up to improved patient care and outcomes, which is better for patients and providers.
Patients with chronic illness may benefit from remote patient monitoring
As the population of the United States trends older and more sedentary, we are seeing a sicker population. The number of people living with a chronic illness in the U.S. is staggering. Today, about 60 percent of Americans have a chronic condition, and 40 percent have two or more.[5] Unfortunately, disease burden is projected to grow. According to McKinsey & Company, disease burden in the United States will grow by about 20% over the next 20 years.[6]
One contributor to an increase in disease burden is our aging population. This is especially challenging because older adults tend to have more chronic conditions – and conditions that require a higher level of clinical care along with efficient and effective care coordination. And as most clinicians know, providing that type of care takes a lot of time and requires substantial resources.[7],[8]
Remote patient monitoring can help keep patients healthier in rural areas
There are 46 million people living in rural areas in the U.S. in 2023. And of those people, one quarter of them report that there are times when they cannot access the healthcare they need.[9],[10]Physician shortage in these areas is likely a contributing factor. There are fewer than 40 practicing physicians for every 100,000 people who live in rural areas. And, according to the CDC, people in rural areas tend to be older and sicker than people in cities and suburban locations.[11]
Supporting at risk patients through telehealth nurses and remote patient monitoring
Telehealth remote patient monitoring plays a critical role in in-home care for patients who are living with chronic conditions. Many older patients with chronic conditions live alone and do not have anyone to help them manage their health and treatment plans each day, which puts them at a greater risk for complications.
With remote patient monitoring, virtual nurses (also known as telehealth nurses) regularly check in with patients about their condition(s). Often, the work nurses do involves leveraging data from patients’ medical monitoring devices, which helps provide personalized care for those patients.
Virtual nurses are typically highly skilled registered nurses that have been briefed in providers’ procedures and understand clinical protocols, remote monitoring best practices, and HIPAA regulations. They are trained to effectively communicate with patients to assess and identify potential issues so those concerns can be proactively addressed. This helps minimize preventable complications and adverse events.
Many primary care providers order remote patient monitoring services to focus on a specific ongoing condition, such as diabetes care or cardiac monitoring. And that monitoring may be provided in part via a durable medical equipment supplier.
Preventing hospitalizations and emergency visits
Another significant benefit of remote patient monitoring is preventing hospitalizations, rehospitalizations, and avoidable emergency department (ED) visits. For example, the Agency for Healthcare Research and Quality (AHRQ) states that nearly one in five patients suffer an adverse event within just three weeks after being discharged from a hospital or an ED.[12] Many of these events are preventable. And preventing hospitalizations also helps with CMS value-based care reimbursement goals by supporting patients most at risk for chronic conditions.
With remote patient monitoring and telehealth visits from a virtual nurse, patients can help patients get regular care that can identify and address potential problems before they devolve into adverse events, often preventing inpatient care and visits to the emergency department.
Improving outcomes with remote patient monitoring
Remote patient monitoring has also been proven to improve outcomes. According to AHRQ, when clinicians regularly communicate with patients, those patients are more likely to adhere to medical advice and care plans. This is particularly true for patients with chronic conditions when working with their providers and adhering to medication and treatment regimens is critical for achieving treatment goals.[13]
Providers can benefit from remote patient monitoring too
Anyone who has been working in healthcare knows the risk of provider burnout, and the pandemic only served to exacerbate it. There is more to do and often fewer resources to do it.
Studies have shown an increase in clinician dissatisfaction due in large part to the greater administrative burden they are carrying due to changes in technology and requirements. For example, new value-based care models and increased demands of electronic health records (EHRs) have left many providers with less time for patient care.
All these pressures are leading to job dissatisfaction, burnout, and depression. According to Medscape’s 2023 US Physician Burnout & Depression Report, 53% of physicians now say they are burned out and 23% say they are depressed. This is up from 42% and 15% respectively in 2018.[14]
In a survey by Nurse.org, eight in ten nurses said their units were understaffed.[15] Patient-to-nurse ratios in some facilities have gone from 1:1 to 3:1 or higher.[16] This is one of the primary reasons given by nurses who say they plan to leave their job.
The bottom line is that the clinician shortage is escalating at a time when the need for clinicians is greater than ever. This is a massive challenge for hospitals and health systems that are trying to balance scarce in-person clinical resources with growing patient volumes, sicker patients, and more complex care. And this impact goes beyond staffing. Patient safety, outcomes, value-based reimbursement, patient satisfaction, and brand reputation are all affected.
All is not lost: Telehealth remote patient monitoring to the rescue
Fortunately, hospitals and health systems can mitigate these challenges by leveraging care coordination services, including solutions like outsourcing to care coordination companies with services that include remote patient monitoring, telephone message and inbox triage and customer contact centers. These services can bring significant benefits to providers – and relief for staff – from the very first day.
Improved reimbursement to cover telehealth and remote patient monitoring
In addition to reducing the impact of clinician shortages, remote patient monitoring supports improved reimbursement. New CPT codes have been added specifically for remote patient monitoring within the past few years.
Remote patient monitoring reimbursement codes[17]
CPT code 99453: Initial Set-Up and Monitoring. Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial set up and patient education on use of equipment. Reflects clinical staff time that includes instructing a patient and/or caregiver about using one or more medical devices.
CPT code 99454: Continued Monitoring over 16 days. Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial device(s) supply with daily recording(s) or programmed alert(s) transmission each 30 days. Includes the medical device or devices supplied to the patient and the programming of the medical device for repeated monitoring.
CPT code 99091: Collecting and Analyzing Physiologic Data. Collection and interpretation of physiologic data (e.g., ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, qualified by education, training, licensure/regulation (when applicable) requiring a minimum of 30 minutes of time, every 30 days.
CPT code 99457: Management Services for Initial 20 Minutes. Remote physiologic monitoring treatment management services, clinical staff / physician / other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month for the first 20 minutes.
CPT code 99458: Management Services for each Additional 20 Minutes. Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/ caregiver during the month; each additional 20 minutes (list separately in addition to code for primary procedure)
Meeting healthcare challenges head on
Healthcare professionals, hospitals, and health systems are fully aware of the current challenges – and those on the horizon. Now is the time to proactively tackle those we can, putting systems and services in place to help mitigate some of the difficulties of a changing healthcare system. Partnering with industry experts like Omega Healthcare for remote patient monitoring is one solution that can provide measurable value.
Our team of clinical experts and registered nurses act as an extension of your organization, providing timely, effective care throughout the entire care continuum. Whether at home or in an ambulatory or acute care setting, your patients will receive the ongoing care they need, often allowing them more freedom, peace of mind, and improved health outcomes.
Omega Healthcare’s remote patient monitoring services include these benefits:
- 24/7/365 continuous patient monitoring, including cardiac monitoring
- Reaching out to a patient’s provider when issues are detected
- Educating patients about their condition and treatment plan
- Ensuring adherence to treatment care plans
- Managing prescription refills
- Coordinating patient appointment reminders
Omega Healthcare Care Coordination Services help enhance outcomes, relieve clinical burden, and improve patient satisfaction, all of which can lead to lower costs and increased reimbursement – something the majority of hospitals and health systems are prioritizing in recent years.
Contact us today to learn more about how Omega Healthcare’s Care Coordination Services can help your organization.
To learn more about our Care Coordination Services including telephone and message triage, remote patient monitoring, and customer contact centers, download our whitepaper, “Key Opportunities to Mitigate Clinician Shortages.”
[1] “A Remote Patient Monitoring Intervention for Patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: Pre-Post Economic Analysis of the Smart Program,” Wanrudee Isaranuwatchai, Olwen Redwood, Adrian Schauer, Tim Van Meer, Jonathan Vallée, Patrick Clifford, National Library of Medicine, December 20, 2018
[2] Ibid.
[3] “Medication Adherence: The Elephant in the Room,” Jennifer Kim, Kelsy Combs, Jonathan Downs, Frank Tillman III, U.S. Pharmacist, January 19, 2018
[4] “Pivot Point Consulting Issues ‘Q2 2022 Healthcare IT Trends Report’ With 6 Key Insights and Implications for IT Leaders,” Pivot Point Consulting, May 4, 2022
[5] “Commentary on Chronic Disease Prevention in 2022,” David Hoffman, National Association of Chronic Disease Directors
[6] “How prioritizing health is a prescription for US prosperity,” Katherine Linzer, Jaana Remes, Shubham Singhal, McKinsey & Company, October 5, 2020
[7] “Older People Projected to Outnumber Children for First Time in U.S. History,” United States Census Bureau, March 13, 2018
[8] Ibid.
[9] “About Rural Health,” Centers for Disease Control and Prevention, May 9, 2023
[10] “The Struggle to Hire and Keep Doctors in Rural Areas Means Patients Go Without Care,” Kirk Siegler, NPR, May 21, 2019
[11] “About Rural Health,” Centers for Disease Control and Prevention, May 9, 2023
[12] “Readmissions and Adverse Events After Discharge,” Agency for Healthcare Research and Quality, September 7, 2019
[13] “Section 2: Why Improve Patient Experience?” Agency for Healthcare Research and Quality, April 2016
[14] “US Physician Burnout & Depression Report,” Leslie Kane, Medscape, January 27, 2023
[15] “What’s Really Behind the Nursing Shortage? 1,500 Nurses Share Their Stories,” Kathleen Gaines, Nurse.org, October 10, 2020
[16] Ibid.
[17] “2021 Medicare Coverage of Remote Physiologic Monitoring (RPM),” Association of American Medical Colleges