Remote physiologic monitoring (RPM)—digital tools that track patients' health data between visits—shows promise for improving chronic disease management and reshaping primary care delivery, according to a new study at Columbia University Mailman School of Public Health. While prior studies have examined how RPM affects patients who use the technology, this is the first study to quantify the impact of RPM on practices, including its effects on practice revenue, care delivery, and resource allocation across patients. The findings are published online in the journal Health Affairs.
"RPM services are often touted as a way for practices to both improve patient care and increase revenue, but it's not a given that this will happen." said study author Mitchell Tang, PhD, assistant professor of Health Policy and Management at Columbia Mailman School of Public Health.
Using national Medicare data, the researchers identified 754 primary care practices that began billing for RPM between 2019 and 2021. The researchers found that primary care practices adopting RPM saw a 20 percent increase in Medicare revenue in the next two years compared with similar practices that did not adopt RPM. Most of the increase stemmed from RPM billing, although roughly one-quarter came from added care management and outpatient visits.
Most surprisingly, according to Tang and his co-authors, adopting practices did not reduce access for patients not receiving RPM. "There was concern that the added time and resources to provide RPM to some patients would come at a cost – other patients in the practice might struggle to get care," said Tang. On the contrary, practices saw more patients overall, with much of the added activity focused on individuals with higher disease burdens—many of whom were non-White or dually eligible for Medicare and Medicaid.
"In a time when many call for a strengthening of primary care, our study offers cautious optimism that technologies like RPM can make primary care more accessible, proactive, and patient-centered," said co-author Ariel D. Stern, PhD, professor of Digital Health, Economics and Policy at the Hasso Plattner Institute, University of Potsdam. However, the authors caution that unchecked widespread adoption could substantially increase Medicare spending. "Thoughtful reimbursement policies, such as evidence-based limits on monitoring duration and patient eligibility, are key to incentivize high value RPM services and ensure sustainability of RPM moving forward."
Other co-authors are Felippe Marcondes, Massachusetts General Hospital; and Ateev Mehrotra, Brown University.
The study was supported by the Commonwealth Fund.
Columbia University Mailman School of Public Health
