TECH- Inconsistent Medicaid coverage for remote patient monitoring hampers adoption

MM Curator summary

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.


[MM Curator Summary]: RPM is taking off in some areas, but needs more money.


Clipped from:

The trend: Remote patient monitoring (RPM) interventions can help low-income individuals get healthier. But more consistent state Medicaid coverage will be necessary for these programs to scale up.

What’s driving the trend? Providers and patients are more bullish on using technology to manage their conditions. So, health systems are using more RPM programs and investors are pouring money into RPM-focused tech startups.

Reimbursement roadblocks: Providers have struggled to capture complete reimbursement from insurers for their RPM programs. Many organizations rely on grants or donations to jumpstart an intervention.

The Centers for Medicare & Medicaid Services recently increased the types of remote monitoring services it will cover for Medicare patients, but Medicaid is a different story.

The opportunity: States are proceeding with caution when it comes to covering RPM services, mostly because they want to see more evidence proving that remotely monitoring patients will be cost efficient for Medicaid and clinically valuable for patients.

Health systems have an opportunity to validate the effectiveness of their RPM interventions, particularly for vulnerable populations.