What You Need to Know: Final 2021 CMS RPM Guidelines

What You Need to Know: Final 2021 CMS RPM Guidelines

We’ve done the hardwork so you don’t have to.

On December 1, 2020, the Centers for Medicare and Medicaid Services (CMS) and Health and Human Services (HHS) issued a Final Rule which went into effect January 1, 2021. The Rule published in the Federal Register on 12/28/20, includes changes to the 2021 Physicians Fee Schedule (PFS), various payment policy updates and finalized provisions of the interim final rules which were issued in 2020 and related to the Public Health Emergency (PHE) and COVID-19.

This 2021 CMS Ruling contains critical updates to codes, especially for Remote Patient Monitoring which we have formatted into a short pdf just for you.

We read every page and brought the key elements down to five pages. If you’re concerned about how the CMS ruling will impact RPM in your practice, click here to read on… we’ve done the hard work for you.

Final 2021 CMS RPM Guidelines

General Guidelines

During the pandemic, a physician may order RPM for both new and established patients. Post-pandemic, RPM may only be ordered for established patients, requiring a prior visit with the billing provider either in person or via telehealth.

Patients must consent to receive RPM services, but consent may be obtained at the time that RPM services are first furnished rather than ahead of time.

RPM may be ordered for patients with either chronic OR acute conditions. RPM codes….read full overview

Learn More

To learn more about DocsInk and our solutions, please visit www.DocsInk.com.

Healthcare and its Consumers:                                                3 Reasons Patients Take Charge in 2021

Healthcare and its Consumers: 3 Reasons Patients Take Charge in 2021

Healthcare Consumerism.
It’s a term representing a time that has finally come.

Thanks in large part to the impacts of the pandemic, the world of patient care has been upended. While COVID-19 has caused big changes in all industries, healthcare is certainly near the top of the list.

As a result, patients are more empowered.

According to Patient Engagement HIT, almost 2/3 (64%) of patients are expected to change healthcare providers if their current provider fails to meet their expectations. That is a big number, and it will have a big impact on the business side of your practice. How so?

Firstly, physician shopping has become pervasive. As medical practices market more, patients become savvier themselves and learn that it is easy to find a new provider.

Secondly, there’s a trend toward ease of navigation. Users expect onboarding to be simple, and the tools to be adaptable. Patients that can’t easily connect with their provider are likely to look for a new one.

And finally, today’s tech-savvy patients are aware that the healthcare industry is capable of facilitating a better, more user-friendly experience. Subsequently, they expect more from practitioners.

What Patients Want

Distancing and unnecessary contact is not something unique to 2020 but will follow us into 2021. Patients have learned to depend more on technology and less on wheels for just about everything. They’ve become familiar with remote care and prefer telehealth whenever it is a reasonable option.

To address patient retention, here are three things healthcare consumers are looking for:

1. Control Over Their Time

For decades, patients have expressed frustration over the difficultly of obtaining a medical appointment. Once made, patients on average show up on time – due to numerous possibilities, the physician often doesn’t, and the waiting game begins.

 

Their demand? No more anxiety and frustration over waiting an hour or more in a doctor’s office just to be seen. Not anymore.

In fact, many are wishing away the waiting room entirely. The idea of sitting in a room full of sick people for an extended stretch of time is outdated in part thanks to virtual waiting rooms.

They make the process significantly more efficient and comfortable for patients. This particular feature of the DocsInk platform has been met with applause from both patient and practitioner. Automated check-ins can be customized for better doctor-patient process alignment resulting in better time management, and higher scores on patient satisfaction surveys.

2. Virtual Expectations

Between January and June of 2020, telemedicine visits rose by 2000%.
You read that right. Not 200%, but 2000%. The doctor-patient experience has been revolutionized.

According to Harvard Business Review, telemedicine is highly effective for younger, digitally savvy patients. However, seniors and the frail often struggle to use the technology.

 

It is incumbent upon the healthcare provider to determine the level of success each patient can have with different types of remote patient monitoring and telehealth solutions.

While Google Meet and Zoom are second nature to many, some physicians’ groups found that a secure telehealth platform built for the healthcare industry, such as DocsInk’s, is better suited to those hesitant to use technology.

3. Better Communication, Improved Continuity of Care

Chronic disease management has taken a turn. While remote patient monitoring (RPM) has been in place for several years, the standardization of telehealth has pushed those with chronic conditions to expect more access to physicians when needed.

Utilization of RPM in situations such as this is only logical. Consider the enormous cost of high-acuity healthcare encounters for patient, payer and provider. Yet also consider the higher cost of not getting care. A recent survey found 10% of respondents were so worried about the impact of the pandemic that they would forego care altogether. This is where telehealth offers control over environment—not having to be in public—and subsequently improves health outcomes.

Yet, beyond online appointments, there’s a new expectation of access that comes out of texting and instant messaging. This is one more way that DocsInk’s platform shines, as it makes it simple for patient or provider to message in real-time. Sudden onset of sharp pain may once have sent patients to the ER. Now, however, they can start by engaging in real-time messaging with the practice and perhaps forego this costly experience, avoiding hospital readmittance fees and improving health outcomes.

The New Era of Healthcare

The public recognizes this is a new era of healthcare. COVID-19, while still rampant and frightening, has instituted a number of positive cultural changes. Patients are more willing to be accountable for their own health, and this often means spending less time in a physician’s office. Practices that embrace this new world are the practices that will succeed.

If you’re still searching for a better way to serve and retain your patients, let’s talk. DocsInk may be the solution you’re looking for.

To learn more about DocsInk’s solutions, email or call 888.577.7409.

RPM: Lowering Hospital Readmissions, Improving Outcomes

RPM: Lowering Hospital Readmissions, Improving Outcomes

Hospital readmissions are a dreadful reality for facility and patients alike. Remote Patient Monitoring is a viable solution for both.

Adverse effects for hospitals include enormous costs. Costs estimated to be in the vicinity of $26 billion annually. Operations suffer and HCAHP scores fall.

The negative effect on patients is also noticed. The undue stress and frustration may make them feel as their health issues are unmanageable.

There is hope, however. Research has demonstrated that the use of Remote Patient Monitoring (RPM) can positively impact both hospitals’ concerns and the patients’ worry.

Although the effect of readmissions on hospitals is widespread, the populations experiencing readmission most are chronic and acute care patients. The top two of these chronic conditions are congestive heart failure (CHF) and diabetes.  For these chronic conditions, remote patient monitoring reduces readmissions and generates recurring revenue. It has also has proven to increase health outcomes in those patients with CHF and diabetes.

    Impact on CHF

    Congestive heart failure is the leading cause of death in the United States. According to the CDC, one person dies every 36 seconds in the U.S. from cardiovascular disease. Progress in fighting the disease, however, improves annually with better medications, use of wireless sensors, and advances in sleep apnea treatment. Yet still, readmittance in this population is staggering. One in every five patients is readmitted within the first 30 days of discharge with a median readmission time of 12 days from initial discharge.

    Readmission is expensive. The national mean cost of a CHF admission per year is $34,000 with an average 30-day, 60-day and 90-day readmission rate of 22.3%, 33.3% and 40.2% respectively. According to the American Heart Association, the costs of CHF readmissions continue to rise, at a current average of $13,500.

    What is being done to help lower readmissions for heart patients?

    Improvements in the management of Medicare beneficiaries, prior to and after initial hospitalization for CHF. This alone has the potential to prevent hospital readmissions. Not only are there cost savings, but persons living with this chronic condition see big benefits as well.

    Secondly, we’re seeing more proof that RPM could be the key. The National Library of Medicine includes a study that demonstrates how RPM directly reduces mortality, hospitalizations, and improves quality of life for CHF patients.

    By remotely monitoring  blood pressure, heart rate, weight and ECG, health plans such as Geisinger have effectively managed patients with heart failure. Since 2008, Geisinger Health Plan has used RPM to reduce the risk of all-cause readmission for their Medicare Advantage members by 77%.

    Geisinger is not alone. Similar studies demonstrate that when RPM is used to treat cardiac patients, readmissions related to heart failure are reduced by 64%. In turn, that results in a net savings of $5,034 per patient, per year when compared to standard care without RPM.

    Impact on Diabetics

    Diabetes is another leading chronic condition. In fact, more than 34 million Americans had diabetes as recently as 2018, according to the CDC. It’s an expensive illness, for those with diabetes incur average medical expenses of $16,752, roughly 2.3 times higher than those incurred by patients without diabetes.

    Diabetes impacts Americans of all backgrounds, all ages. Veterans seem to suffer from it in larger numbers with a quarter of all veterans having diabetes. This led the Veterans Health Administration (VHA) to conduct a study on diabetic veterans, each of whom had two or more prior hospitalizations or ER visits.

    The VHA found when RPM was used for one year re-hospitalizations were reduced by 50% and emergency room visits were down 11%.  Additionally, the average number of bed days were three days shorter. And finally, 95% of these veterans reported a high patient satisfaction rate with the RPM program. Satisfaction drives usage, and therefore ongoing health benefits can be expected.

    Of course, it’s not just the VA that is looking to determine the efficacy of RPM programs. Comparison studies have been conducted by many other independent researchers, and the results are encouraging. Those using RPM saw a 77.2% improvement in their health, versus only 70.4% improvement in stability for those not using RPM solutions.

    Benefits: Clinical and Fiscal

    Based on the results of the above-mentioned research, patients benefit greatly from use of remote patient monitoring solutions. And of course, we have noted the benefits that hospitals and physician groups see. But there is also great benefit to insurance payers.

    The Coalition to Transform Advanced Care (CTAC) and America’s Health Insurance Plans (AHIP) published an article which sites several studies. Each of these reported positive clinical and fiscal benefits of RPM programs.

    Patients in RPM programs reported significantly fewer care requests:

    • 51% fewer on-call urgent visits
    • 47% fewer physician visits
    • 41% fewer phone calls related to patient care
    • 40% reduction in hospitalization of senior citizens
    • Medicare members are 76% less likely to experience hospital readmissions when using RPM
    • 94 – 97% of patients noted their satisfaction with the RPM programs.

    Implementing RPM with DocsInk

    With DocsInk’s RPM solution, implementation is seamless. Account setup and EHR integration takes only minutes to complete and patient onboarding has never been easier. DocsInk’s solution allows clinicians to quickly monitor, assess and address their patient’s health in real time and instantly bill for services rendered. With 475+ integrated monitoring devicesand multi-configurationRPM programs, DocsInk was built to fit the needs and workflow of any size healthcare facility. DocsInk’s solution can help manage chronically ill patient populations and in turn, decrease hospital visits, increase provider’s monthly revenue and improve overall health outcomes.

    To learn more about how your organization can benefit from DocsInk’s RPM Solution, email or call 888.577.7409.

    Increase patient engagement. Reduce costs. Maximize efficiency. Improve health outcomes.

     

    Click Here to learn more about DocsInk’s RPM solution

    RPM – The Right Tool for COVID-19 and Beyond

    RPM – The Right Tool for COVID-19 and Beyond

    Remote physiologic monitoring (RPM) technology, also called remote patient monitoring, is playing a vital role during the current pandemic. It excels in connecting patients to care teams, providing real-time clinical data needed to control symptom and disease progression. As COVID-19 continues to spread, our country faces the unprecedented challenge of managing health in a safe and effective manner.

    Time and resources are valuable commodities for all healthcare organizations — especially as medical professionals battle this pandemic. Clinicians adopt RPM to monitor, assess and address patients’ health, instantly receiving vitals and data from thermometers, pulse oximeters and blood pressure monitors. With real-time insights come fast response, better prioritization and triage of patients, and faster delivery of healthcare when every minute counts.

    Patients no longer have to rely on their own discretion as to whether their rising temperature or shortness of breath warrant a visit to the nearest emergency room. With RPM technologies, they have confidence that they are being monitored; a change in their health status will be immediately conveyed to their care team. RPM expedites the delivery of medical care in a safe and virtual manner, as face-to-face treatment now poses too large of a risk potential in many cases. The Centers for Medicare and Medicaid Services (CMS) recently released new regulations covering these services for patients with acute conditions.

    CPT Codes and RPM Adoption

    The recent healthcare crisis put a spotlight on the value that tools like RPM and wearable devices in the management of patient outcomes. It was in 2019, however, that their use became more common. That is when CMS published several new RPM Current Procedural Terminology (CPT) codes. These CPT codes more clearly improve reimbursement for the work typically performed around RPM service programs. This includes issuing devices to the patient and training them on its use. It also supports electronic transmissions, monitoring clinical data, and interactively communicating with patients.

    These newly released codes successfully boosted physician adoption. In Spyglass Consulting Group’s 2019 survey, 88% of healthcare providers reported either purchasing or evaluating RPM technologies. Providers have found RPM valuable in managing high-risk populations. It also led to expansion of chronic care management programs, aiding in the successful transition to value-based care models. RPM is highly effective in treating prevalent diseases, such as diabetes, congestive heart failure, hypertension, chronic obstructive pulmonary disease, and asthma. Studies demonstrate that they play a significant role in substantially reducing readmission rates and overall costs of care.

    In 2020, CMS further relaxed their RPM guidelines. Clinical staff can now perform these services under the supervising physician’s general supervision based on CMS’ incident-to guidelines. This allows care providers to work efficiently, freeing up physician time for more complex treatments and procedures. It also expands the potential business models for RPM programs, as the physician doesn’t have to be in the same physical location while the services are performed. 

    Medical Benefits of RPM

    DocsInk uniquely positions medical professionals to successfully implement an RPM program. It simplifies the day to day use of remote patient monitoring for medical professionals by seamlessly connecting to any wearable device. Additionally, it offers customizable clinical alert notifications, facilitates templated patient surveys, streamlines interactive patient communications, and instantly bills for all professional services rendered.

    We are all working to gain control over the global health crisis. Yet we must simultaneously navigate value-based care, manage chronically-ill patient populations, and provide general health coaching. That’s why we created a new solution. DocsInk’s RPM solution offers a strong ROI, improved workflow efficiencies, and the tools to achieve patient goals.

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