Medicare Remote Patient Monitoring Use Shot Up During Pandemic

A study published in JAMA Internal Medicine found a substantial increase in the use of remote patient monitoring (RPM) services within the Medicare population amid the COVID-19 pandemic, which could lead to a rise in costs if usage continues to increase at the same rate.

Following the expansion of RPM coverage in Medicare in 2019, questions regarding its efficacy and use have arisen. To determine how RPM trends varied before and during the COVID-19 pandemic, researchers reviewed Medicare RPM claims data from Jan. 1, 2018, to Sept. 30, 2021.

Researchers used monthly claims volume per 100,000 enrollees to measure general RPM use. They found that the number of claims per 100,000 enrollees reached 594 in September 2021, significantly higher than the 91 claims per 100,000 enrollees in February 2020. This represents a 555 percent increase. 

Researchers also examined the use of continuous glucose monitoring (CGM). There was a 42 percent increase per 100,000 enrollees in claims related to CGM use.

Regarding specialties, they noted that primary care physicians were the most common provider of general RPM, offering 63.1 percent of the services, followed by cardiologists (19.7 percent) and pulmonologists (4.1 percent).

Among diagnoses treated using general RPM services, hypertension was the most common (62.5 percent), followed by diabetes (8.3 percent), sleep disorders (3.9 percent), hyperlipidemia (3.5 percent), and heart disease (3.2 percent).

But, if this sharp increase in RPM use that resulted from the COVID-19 pandemic persists, cost implications will also likely rise, researchers said. According to data from the Centers for Medicare & Medicaid Services, among the 20 million patients who received a diagnosis of hypertension or diabetes in 2019, the average accrued cost per patient was $2,270 for general RPM services.

Thus, researchers noted that providers must determine if RPM is a good investment where the benefits outweigh the costs.

Despite the single noted limitation of using diagnosis codes to categorize RPM, researchers believe that the study provides valuable information regarding the evolution and potential future of RPM among Medicare patients.

As the popularity of RPM grows, several provider organizations have recently entered into partnerships to launch hospital-at-home programs.

In June, Appalachian Regional Healthcare announced plans to implement a home hospital program that leverages Biofourmis' technology to deliver quality acute hospital-level care in patient homes. Patients participating in the program will receive biosensors, blood-pressure cuffs, pulse oximeters, and weight scales to gather physiologic data.

Even low-resource settings, like federally qualified health centers, are increasingly leaning on RPM to care for vulnerable populations. But there are several issues FQHCs face when setting up RPM programs, including limited staff and low engagement among patients.