When it Comes to Telehealth Reimbursement, ‘Just Start Billing’

The use of remote patient monitoring (RPM) is becoming more common with in-home care providers and has proven to be a value-add to many organizations. But questions related to receiving reimbursement for RPM devices and services through Medicare still exist.

Broadly, the use of remote patient monitoring is gaining momentum across senior care even outside of the home. RPM devices alert providers to their patients’ downward health trends and can play a key role in reducing hospital readmission rates.

Furthermore, as the number of older adults that have chronic conditions continues to grow, remote patient monitoring can be a tool to address caregiver shortages.


“In an ideal world, we might want to have a nurse’s aide or a professional with every elderly person, in case something happens to them, but that’s just not going to happen,” John Whitman, executive director of the TRECS Institute at The Wharton School, said earlier this month during a panel discussion at the Senior Care 360 conference in National Harbor, Maryland.

Founded in 2004, TRECS Institute — which stands for “Targeting Revolutionary Elder Care Solutions” — is a nonprofit organization that aims to improve care for seniors while reducing health care costs.

While providers are open to embracing remote patient monitoring, the issue of how it’s paid for regularly comes up. Typically, devices are not reimbursed through Medicare — but that may be starting to change, according to Whitman.


“There is some pretty good reimbursement,” Whitman said. “CMS just passed 60 new codes in January for various telemedicine approaches. We are still working through some of the idiosyncrasies. I’ve spent a lot of time talking to Medicare in terms of how we are going to go for this and their bottom line response was, ‘Just start billing and we’ll see how it goes.’”

Kerri Pendley, director of health care strategy at FirstLight Home Care; Allen Pindell, senior vice president of information services and analytics at Lexington Health Network; and John Hopkins, president for CCS Healthcare, joined Whitman during the panel discussion.

Recently, FirstLight Home Care has begun to implement remote patient monitoring into its care strategy through a pilot program.

Cincinnati-based franchise company FirstLight Home Care provides about 100,000 hours per week of companion, personal and dementia care services to nearly 4,800 clients across more than 254 locations in 34 states.

FirstLight Home Care wanted to incorporate remote patient monitoring for a number of reasons, Pendley said, such as improving patient outcomes, reducing hospital readmissions and strengthening partnerships in post-acute care.

In February, the company partnered with HNC Virtual Solutions, a global telemedicine software company. The partnership provided FirstLight Home Care’s remote patient monitoring application and blue-tooth devices that reported vital signs. The company also partnered with CareHalo, a chronic care management company.

“We have implemented this as a pilot,” Pendley said. “Our plan is to run this pilot through 2019, and then roll it out in 2020.”

For now, it’s still too early to talk financial return on investment, but remote patient monitoring allows FirstLight Home Care an additional offering to help people age in place, according to Pendley.

“We see it as being a differentiator for our system at this point,” she said. “It will allow for more real-time reporting, and intervention. The longer we can keep an individual in their home and under our services, as independent as possible would be our goal.”

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