Peterson Healthcare Center: Policy recommendations for 3 telehealth technologies
The use of remote monitoring technology has surged in recent years, and in a new report, the Peterson Healthcare Center provides policy makers with advice on covering and paying for these services.
Peterson Healthcare Center is a nonprofit organization dedicated to making healthcare more affordable. In 2023, the organization established the Peterson Health Technology Institute (PHTI), an independent evaluator of digital health solutions. The report relies on the results of three evaluations of the tools for diabetes, hypertension and musculoskeletal disease by PHTI, as well as an analysis of Medicare and Medicaid billing trends.
Remote monitoring includes remote physiological monitoring (RPM) and remote therapy monitoring (RTM). The former tracks the patient's physical data, such as weight or blood sugar, while the latter tracks the patient's self-report data, such as pain or activity levels.
The report notes that health insurance bills for remote monitoring have soared in recent years. Federal traditional Medicare spending in RPM increased from $6.8 million in 2019 to $194.5 million in 2023. RTM spending increased from $2.2 million in 2022 (when the release code was released) to $10.4 million in 2023.
Furthermore, patients undergoing long-term monitoring have risen steadily, although studies have shown that the greatest benefits occur within the first few months. The report found that some providers continue to pay for remote monitoring services after patients may receive further benefits.
Based on these issues, Peterson Healthcare Center has made the following three recommendations for telehealth technology developers:
1. Coverage and reimbursement should be based on performance: Policy makers and payers should create “evidence-based, condition-specific remote monitoring duration limits and require active re-determination of medical essentials in order to continue to cover these services beyond these limits”. They should also link coverage to the clinical effectiveness of remote monitoring.
2. Improve access and use of high impact services: Policy makers and payers should eliminate the use of low-performance remote monitoring technologies and increase access to high-performance tools for those who need them.
“Today, there is little penetration rate for using RPM or RTM in rural areas, as high-impact remote services need to play a central role in the rural population because of higher rates of chronic disease, shortage of providers, and longer distances of care,” the report said.
3. Pre-data collection for remote monitoring services: Payers and policy makers need better data to understand how these technologies are implemented, what digital solutions, technologies are used for treatment and other information conditions. This will make it easier to make evidence-based coverage and reimbursement decisions for remote monitoring services.
“As we adopt exciting new technologies to expand care beyond the walls of doctors’ offices, we need to design payment models that align with the clinical benefits of patients,” Caroline Pearson, executive director of Peterson Healthcare Center, said in a statement. “This means ending ‘forever code’ to incentivize long-term billing for invalid care and designing payments to repay providers within a time period when they should actively monitor and manage patient illness.”
Photo: Solstock, Getty Images
