elenabs/istock via Getty Images
Adopting RPM linked to 20% hike in Medicare revenue
New research reveals that practices adopting RPM saw higher Medicare revenue, which has policy implications, as it could result in billions in additional Medicare spending.
Primary care practices that adopted remote patient monitoring, or RPM, between 2019 and 2023 saw a 20% jump in Medicare revenue compared to practices that did not, according to new research.
Published in Health Affairs, the study aimed to examine the practice-level effects of RPM adoption. Researchers analyzed national traditional Medicare claims, identifying 754 primary care practices that began billing for RPM in 2019-2021. Most of the RPM-adopting practices (98.1%) were matched to 2,215 control practices. RPM-adopting practices were more likely than their non-adopting counterparts to be part of an accountable care organization, provide care management services and serve minority and dually eligible patients.
Researchers also examined a range of practice-level outcomes through 2023, including total practice revenue from traditional Medicare and the total number of outpatient visits delivered.
Compared to matched control practices, RPM-adopting practices experienced a 20% increase in revenue from traditional Medicare over a two-year period. The increase was driven primarily by the addition of RPM services.
Additionally, RPM-adopting practices increased their patient panel sizes, seeing 2.9% more patients each quarter. They completed 4.2% more outpatient visits, with the increase primarily driven by the use of telehealth.
These increases in practice activity are partially explained by a 2.7% increase in the number of billing providers associated with the practice, the study authors noted. They posited that the increases in practice activity could also reflect an increase in billing per provider, potentially enabled by adding medical assistants, nurses or support from external RPM vendors; however, further research is needed to investigate this.
The researchers stated that the study findings have policy implications, as a 20% increase in traditional Medicare revenue across all primary care practices would result in approximately $6 billion in additional annual spending. However, limiting RPM coverage could mitigate the benefits of RPM.
"Thoughtful guardrails, such as evidence-based limits on monitoring duration and patient eligibility, may help strike the right balance," the researchers wrote.
The study results align with previous data showing that RPM utilization and spending within Medicare are growing rapidly.
A Peterson Center on Healthcare report released earlier this year revealed a 10-fold increase in traditional Medicare patients using RPM services from 44,500 in 2019 to 451,000 in 2023. Traditional Medicare claim payments also skyrocketed, jumping from $6.8 million in 2019 to $194.5 million in 2023.
New payment codes may further add to Medicare spending in the coming year. The 2026 Medicare Physician Fee Schedule final rule added new RPM billing codes that will pay healthcare practitioners for collecting RPM data for the first 10 minutes and for two to five days within a 30-day period. Current billing codes only pay practitioners for collecting at least 20 minutes of data and for 16 days of data collected every 30 days.
Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.
