CMS Changes Remote Monitoring Pay: What Health Execs Should Know

August 29, 2018

Executives speculate on what’s next following the remote patient monitoring CMS rule.

In July 2018, the CMS announced its proposed 2019 Medicare Physician Fee Schedule, which includes the adoption of reimbursements for remote patient monitoring technology for home healthcare. CMS officials say the proposed change to the Home Health Prospective Payment System “encourages value over volume and removes incentives to provide unnecessary care.”

The proposed additions and changes will allow home health agencies to report allowable costs of remote patient monitoring to Medicare. CMS states the goals of the proposed rule are to increase data sharing and care coordination at home health agencies with patients, caregivers, and providers. CMS is accepting comments on the proposed rule through August 31, 2018.

Along with the reimbursements, CMS is also proposing to eliminate the requirement that physicians estimate the amount of time spent on longer-skilled activities as a way of certifying home healthcare.

“[The] proposals would give doctors more time to spend with their patients, allow home health agencies to leverage innovation, and drive better results for patients,” said CMS Administrator Seema Verma.

Eric Rock, CEO of Vivify, says that the proposed rule is the strongest indicator from CMS that the shift to value-based care has becoming a priority. The precedent that CMS is setting with the remote monitoring reimbursements will allow for patients to receive care in a more convenient manner and predicts that there will be significant cost savings over time, Rock says.

“In the past, the focus has been on reimbursement for virtual visits. This rule includes remote care to keep patients out of high costs settings,” Rock says. “This is a shift toward payments for time and quality of care compared to event-based payment.”

Rock says that based on the language of the current rule, it isn’t clear whether the reimbursement would be available to managed care organizations. Vivify, an end-to-end remote care management platform, has asked its home health care provider customers to submit comments and questions about the proposed rule to CMS via its website.

“Our customers are in the environment that would be covered by the new rule. We hope CMS will shift quickly to cover managed care organizations, too,” Rock says.

Tim O’Malley, president of EarlySense Inc., says that the CMS proposed rules that embrace communication technology will lead to a major shift in managed care organizations.

“There is a much stronger focus on quality and finding tools and technologies that help organizations manage complex patients without bouncing them back to the hospital,” O’Malley says. “These bounce backs now not only impact the hospital but have a direct impact on post-acute providers. The new ruling helps facilities manage patients remotely with the goal of providing timely intervention avoiding rehospitalization.”