Remote patient monitoring (RPM) has been making headway for several years, but it took a devastating COVID-19 pandemic to send RPM and telehealth into overdrive. Providers and vendors alike had to scramble to adjust and expand health platforms and reconfigure the tools necessary to meet the new demands. This blog will discuss the technological steps taken so far, and how technology vendors such as Phillips and SOC Telemed, and insurers as well as CMS are responding to the newest developments, and their impact on telehealth billing and reimbursement.
Meeting healthcare challenges with innovation
Vendors of software and technologies have been quick to respond with innovative platforms and tools not only for COVID-a9 surveillance but for utilization within a post-pandemic future. The one possible silver lining of the pandemic is that it laid bare the weaknesses of the current healthcare systems and technologies, according to Christine Storm, head of Phillips’ virtual solutions division.
She believes that any solutions will also need to accommodate the continually evolving areas of in-home care, as preferred by more healthcare consumers.
Jason Hallock, MD, and chief medical officer for SOC Telemed, adds that the pandemic gave us (providers and vendors) a glimpse into how medicine will look in the future, with more than 25 percent of current in-hospital care predicted to be delivered more efficiently by telemedicine.
To illustrate how far things have come in just the past few months, Zoom has launched its own health division, and Amazon and Microsoft both have expanded telehealth offerings beyond their own employees.
As providers become more open to the benefits of telemedicine as well as remote patient monitoring, improved patient engagement and a deeper understanding of their health outside of the doctor’s office are a couple of the immediate positive effects brought about by improved technologies and platforms.
With a reduction of in-person care resulting from attempts to stop the virus’ spread, as well as improve diagnosis and treatment, the healthcare industry has turned to mHealth technologies and devices, such as smartphones, other smart devices, sensor-embedded clothes, and other means of early detection of the virus before they have a chance to spread it further.
Taking the cue, companies such as FitBit, Garmin, and Apple are developing new wearables, along with the platforms allowing healthcare consumers to do more self-monitoring at home.
As the pandemic appears to be winding down somewhat, many providers want to continue with their RPM programs, by applying the technologies to different populations, particularly those with chronic conditions, as well as those needing post-discharge rehab, and even patients who would otherwise be placed in skilled nursing facilities.
In addition, RPM programs have given providers and vendors as well as payers a chance to test new technologies and the health plans to pay for them.
Even now, many health plans are already looking ahead well beyond 2022 into 2025 for emerging opportunities to collaborate with providers and vendors to lower system costs while providing more patient-centric care. Government regulations such as those of CMS, are also converging with the markets in support of these initiatives. Now would be a good time to formalize your value-based care (VBC) protocols and prepare your practice for the newer models of coverage based on population health, with the goal of delivering a seamless patient experience.
Twenty-five senior leaders in the health plan industry were polled about their views and insights about what may be in store for 2025 and beyond. Here are their top four:
- Personalized care availability is expected to increase
- AL/ML practices can expect significant returns
- Government regulations are predicted to help overcome barriers to technological innovation
- VBC arrangements are expected to increase with higher levels of provider participation
Preparing for the future
To summarize, we are seeing a persistent theme emerging within the healthcare industry, and it’s about making healthcare move away from a one-size-fits-all approach and become more value-based and personalized. Now that healthcare providers are taking up the VBC approach, health plans are taking another look at leveraging and managing data aimed at meeting patients’ specific needs. Although not yet at the point of being able to tailor plans for individual patients, there is a move toward engagement with members to develop more personal, curated health plans. It might be a good idea to follow the examples of banking and retailing of offering personalized members’ experiences.
Regulatory changes and mandates for interoperability have presented great opportunities for health plans that will free data from the current data silos. Real-time data plus payer-provider integration will result in opening real-time analytics. No longer will data silos be constraints as health plans move forward to a more level playing field of interoperability capabilities geared more toward the member experience. When that day arrives, everyone wins.
In the face of one of the worst pandemics of modern times, medical practices and other health organizations are proving to be up to the challenges of innovative diagnoses, treatments, and utilization of personnel. While insurers, including CMS and others, are also trying to adapt to a changing healthcare environment, many of them still lag behind the newest lifesaving technological advances. It makes sense, then, to partner with a company that has stayed on top of the latest reimbursement updates and can “translate” it into higher reimbursement and RCM.
M-Scribe Technologies, LLC offers practices of all specialties and sizes a chance to optimize their billing and reimbursement rates, especially if utilizing newer technologies and platforms such as telemedicine and RPM. From sending out “clean” claims properly coded and documented, to tracking reimbursement progress and beyond, our medical billing, credentialing, and practice management expertise can help your practice or organization achieve its potential in growth and leadership.
Contact us at 770-666-0470 or email for a complimentary consultation with one of our experienced counselors to learn how you can take better control of your RCM and practice management protocols while remaining fully compliant with all federal, state, payer, and other regulations and guidelines.