The COVID-19 pandemic forced every healthcare provider to rethink how they deliver high quality care to their patients. Seriously - anyone responsible for patient care, I’m talking health systems and home health providers, but also payers, hospice and palliative care organizations, and yes, physician groups.
Prior to the pandemic, physician groups were notorious for dragging their feet towards the telehealth train, and often, for understandable reasons. Lack of reimbursement, fear of new technology, uncertainty of patient adoption, workflow changes, etc., all contributed to physicians not being eager to jump on board.
Now, there is much more data and readily available use cases showing telehealth works and is a way to increase revenue for physician groups.
Nowadays, physician groups are using telehealth to:
- Help manage their patients’ care at home
- Deliver quality care
- Drive revenue growth
- Improve access to healthcare
- Limit staff and patient exposure to COVID-19
A Shift Sparked by Necessity, Sustained by Adoption
Since March of 2020, patients have been understandably hesitant to see their providers in person. Fear of the pandemic was prevalent and patients wanted to remain as safe as possible. As a result, they turned to telehealth solutions as an alternative or augmentation to in-person care.
I’m not going to go down the route of “why telehealth is here to stay;” this has been well documented already, instead, let’s talk about how physician groups are seeing success with remote patient monitoring and telehealth.
Physician Groups are Responding to What Their Patients Want
There’s no doubt about it - patients want to receive care at home, and they don’t want to wait for care when they need it.
But how are physician groups making this happen in practice?
Starting with these 5 steps will get your organization on board the telehealth train comfortably, efficiently, and quickly:
1. Determine how telehealth will fit into your organization’s continuum of care
How is your organization going to use telehealth? Determine which patient populations will benefit from access to telehealth and RPM—the service can benefit a range of patient populations. Will you offer telehealth to high-risk chronic patients, as a way to replace in person routine visits for patients, for post-surgical patients, for behavioral health patients? Maybe you’ll offer the service to all of the above, a combination, or a different population your organization serves.
Regardless, you need to set out with clear intentions for how your organization will be using the technology day-to-day. RPM can be used for vital monitoring, virtual visits, education, symptom surveys, medication, reminders and more.
2. Evaluate technology partners
You’ve determined which patient populations your telehealth program will initially serve, now what? You select a telehealth partner It’s essential to work with a vendor who supports the features you’re looking for (as determined in step 1). In addition to that, it’s important to work with a partner that will assist you with planning, assessing success, and scaling your program.
Start with asking these key questions of the partners you evaluate:
- Are they HIPAA compliant?
- Can they integrate with my EMR?
- How do they support my organization during planning, implementation, and my program’s tenure?
- What support services are available to help meet our clinical, operational and financial goals?
- How do they assist with reimbursement?
These are just a few questions to get you started. Be sure to do your research before selecting a partner.
3. Research reimbursement and payment opportunities
Did you know remote patient monitoring can be a source of revenue for your physician group? Before starting your program, be sure your billing team is up to speed and that you have a plan in place for capturing changes to reimbursement.
Most RPM payments are billed to RPM services under 4 CPT codes: 99453, 99457, and 99458. The services, including initial patient enrollment, a monthly payment to manage the RPM device and reading, and optional clinician care management, can earn your practice up to $210 per patient, per month. Look into how organization’s like yours are using reimbursement and CPT codes to drive revenue.
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99453 — Initial set-up: 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 |
99454 — Device: 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 |
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99457 — 20 minutes of monitoring per month: Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month |
99458 — Additional 20 minutes per month: 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; additional 20 minutes |
Beyond the CPT codes, look into what commercial insurance companies are doing and whether reimbursement for RPM is part of their telehealth coverage. Look into coverage for RPM at the state level as well.
4. Educate clinicians and patients
It is essential that your staff (physicians, nurse practitioners, physician assistants, RNs, medical assistants, etc), are bought into using telehealth for patient care. Make sure that they understand how telehealth and RPM will be used by your practice and more importantly how it is going to positively affect their day to day workload.
It’s equally important for patients to be engaged and interested in the technology. Better engagement → better health outcomes and results. It’s on your organization to help patients feel empowered with the technology, to help them understand what telehealth should (and shouldn’t) be used for, and what to do if they experience challenges with the program.
5. Analyze the data on an ongoing basis
Be sure to continuously evaluate success metrics. Is your telehealth program achieving the goals you set out to achieve? For example, have you been able to see more patients in a shorter period of time, have you reduced ED visits, have you improved patient<>provider relationships? Evaluating your program on a continual basis will help your organization focus on what’s working, and pivot when things are not.
Telehealth and RPM can help your organization reduce overall healthcare costs and increase revenue. RPM doesn’t have to require a tremendous amount of work for your providers, yet it offers patients and family members peace of mind that someone is “monitoring” the status of their condition, and available more readily should questions, symptoms, or other needs arise.
