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    The Medical Group Management Association’s most recent MGMA Stat poll asked healthcare leaders, “Does your practice offer remote patient monitoring?” Only 22% said “yes,” while 78% said “no.”

    The poll was conducted April 20, 2021, with 836 applicable responses.

    These results reflect a similar level of RPM implementation from a Sept. 15, 2020, MGMA Stat poll in which 21% of healthcare leaders said their practices offer RPM.

    But little movement in RPM expansion does not necessarily mean that growth in telehealth has stalled out: 29% of the healthcare leaders who responded “no” to the most-recent poll said they have added other telehealth services within the past six months, showing that some practices are still seeking ways to grow virtual care delivery long after the initial boom in telemedicine in the first half of 2020.

    What’s next for telehealth in 2021?

    While many patients report growing satisfaction with telehealth during the pandemic, the future of telehealth remains uncertain: A Feb. 9 MGMA Stat poll found an almost even split among healthcare leaders’ expectations for telehealth utilization throughout 2021: 31% expected an increase, 34% expected “no change” and 35% said they expect utilization to decrease.

    Similarly, concerns about reimbursement have many practice leaders in a wait-and-see stance on telehealth. The Medicare Payment Advisory Commission (MedPAC) “recommends Congress and CMS temporarily continue some of the telehealth expansions under Medicare but revert to lower payment rates,” as reported by Modern Healthcare.

    Additionally, a new article published in The New England Journal of Medicine by a team of healthcare policy researchers points to key issues with “volume, value and appropriate use” of RPM services, including:

    • RPM technology often lacks established standards for demonstrating clinical effectiveness in disease management.
    • More studies, “either designed as clinical trials or leveraging real-world data,” will be needed to support clinical use and coverage of an RPM device by the Centers for Medicare & Medicaid Services (CMS).
    • Incentives for RPM services will vary between providers in predominantly fee-for-service models and those in alternative payment models, such as bundled payments.

    More insights on RPM

    Real-world success with RPM

    Janis Coffin, DO, FAACP, FACMPE, CCE, chief transformation officer, Augusta University Health System — a guest on the April 14 episode of the MGMA Insights podcast — said her team went beyond video and telephone visits with patients during the pandemic by working with NavCare to begin remote patient monitoring of their most-vulnerable patients, especially those with two or more chronic conditions.

    Depending on those conditions, the team would send patients certain equipment (e.g., a pulse oximeter and blood pressure cuff for COPD patients or a glucometer for diabetic patients). “Those patients would take their vitals every day … and that information will then be uploaded through NavCare into our electronic medical record,” Coffin said. With that data, patients’ vitals were assessed based on clinical protocols, and anything outside of the norm would be flagged for a provider.

    Coffin had a unique experience in piloting the program, as her parents — who live two time zones and more than 1,500 miles from Augusta — adopted the RPM devices. “I can see what they’re doing every day: If they’re taking their medicine, if they are taking their vitals,” Coffin noted. “It really does give peace of mind not just for myself but others who’ve signed up for the program.”

    That level of ability to reach out and monitor patients beyond the brick-and-mortar practice facilities then grew into a Hospital from Home program, in which COVID-19 patients who were discharged could have their oxygen levels tracked at home. “We’re able to free up beds for more acute patients to come into the hospital,” Coffin said, noting that getting patients out of the hospital reduced the length of stay and helped bring costs down.

    Overall, this newfound ability to have close to real-time data on patients is a major improvement over more traditional patient visits in person. “In the past, if a patient of mine had diabetes, hypertension or hyperlipidemia, they may see me every three months, but in that 90-day period there’s nobody calling them” regarding important vital signs for blood pressure, blood sugar or medication adherence. “With [RPM], they’re uploading vitals every day. If things fall out of the norm, someone is calling them. … So someone has a touch point with that patient in between the three months that I see them.”

    Do you have any best practices or success stories to share on this topic? Please let us know by emailing us at connection@mgma.com.

    JOIN MGMA STAT

    Our ability at MGMA to provide great resources, education and advocacy depends on a strong feedback loop with healthcare leaders. To be part of this effort, sign up for MGMA Stat and make your voice heard in our weekly polls. Sign up by texting “STAT” to 33550 or visit mgma.com/stat. Polls will be sent to your phone via text message.

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