In my last blog post I referenced the launch of the Intel® Health Application Platform for remote healthcare and also the recent solicitation for comments on “Current Year 2018 Revisions to Payment Policies under the Physician Fee Schedule” (PFS), in which the Centers for Medicare 7 Medicaid Services (CMS) asked for input on how to pay for remote patient monitoring and where it could be used. Earlier in November, when CMS published the final rule for the PFS, we were excited to see that Current Procedural Terminology (CPT) code 99091 had been unbundled. The new rule allows for the billing of “Collection and interpretation of physiologic data (eg, 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”. This effectively means that reimbursement for remote patient monitoring has been unlocked.
The good news does not stop there. CMS also said: “We look forward to forthcoming coding changes through the CPT process that we anticipate will better describe the role of remote patient monitoring in contemporary practice and potentially mitigate the need for the additional billing requirements associated with these services.” Indeed, the American Medical Association has recently created three CPT codes for “Chronic Care Remote Physiologic Monitoring” which, if taken on board by CMS, could be included in the 2019 revision of the PFS.
Perhaps less commonly perceived as associated with remote patient monitoring but an equally relevant development is the fact that CMS upgraded to classify as “high” the Clinical Practice Improvement Activity (CPIA) of “Engage Patients and Families to Guide Improvement in the System of Care” in the 2018 Quality Payment Program (QPP). The QPP, created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), defines the way Medicare rewards clinicians for value over volume. By classifying CIPA as “high”, CMS will be rewarding clinicians more to “Engage patients and families to guide improvement in the system of care by leveraging digital tools for ongoing guidance and assessments outside the encounter, including the collection and use of patient data for return-to-work and patient quality of life improvement.” Further, “platforms and devices that collect patient-generated health data (PGHD) must do so with an active feedback loop, either providing PGHD in real or near-real time to the care team, or generating clinically endorsed real or near-real time automated feedback to the patient, including patient reported outcomes.”
Intel applauds CMS for these decisions and has long advocated for the reimbursement of remote patient monitoring. Remote patient monitoring helps meet patients’ expectations, bridges distances across sparsely populated areas, places emphasis on prevention, and frees up expensive emergency care by limiting avoidable hospitalizations. Aside from these clear benefits, remote patient monitoring drives the secure flow of data between endpoints – through our networks and data centers. Reimbursement of remote patient monitoring not only eases the strain of digital healthcare costs, but in doing so, it also creates an opportunity for the use of more data to deliver better health outcomes. Intel is helping further a technology environment of billions of smart connected devices, improved connectivity through the transformation to a 5G infrastructure and the use of advanced data analytics and artificial intelligence in the data center and in the network. We call this environment the Virtuous Cycle, and the use of remote patient monitoring is an important aspect of that environment that will help save lives.
We look forward with great hope that 2018 will be the turning point for the adoption of remote patient monitoring in Medicare, as novel technologies like Intel’s Health Application Platform and others will be leveraged to provide better and more efficient care to patients.