CMS proposal builds remote patient monitoring into home health reimbursement

Philips Wearable Biosensor
A proposed rule from CMS would factor remote monitoring costs into reimbursement. (Philips)

Home health agencies may soon be able to include the costs associated with remote patient monitoring into Medicare reimbursement.

Under a proposed payment rule (PDF) released by the Centers for Medicare & Medicaid Services (CMS) on Monday, home health providers would be able to include the costs of remote patient monitoring as an allowable cost in the home health agency’s cost report.

Although home health providers would not be directly reimbursed for the installation and use of equipment, CMS uses cost reports to determine if home health providers are being paid appropriately. Currently, remote monitoring technology could not be included in those cost reports, and officials say the change could incentivize broader use of technology that can improve care through access to real-time data.

The proposal would allow home health agencies to report all costs associated with the technology, including infrastructure upgrades and equipment, as well as wage and labor costs associated with using the equipment, a CMS official said on a press call Monday.

The proposed rule defines remote patient monitoring as “the collection of physiologic data (for example, ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver.” The agency included specific examples where a home health provider gave tablets to patients with chronic conditions, which were used to transmit vital signs on a daily basis.

The tools are meant to augment in-person care to help avoid unnecessary emergency department visits and hospitalizations, according to a CMS spokesperson, but there are no restrictions on what types of technology can be used. 

Digital health proponents have said new technology can help seniors age in place, although recent research shows devices like wearables have a limited clinical impact.

CMS Administrator Seema Verma told reporters the shift aligns with the agency’s push to help providers innovation, adding that it would allow patients to share real-time data with caregivers and push providers to “use technology to track clinical data for monitoring and analysis.”

Beginning this year, Medicare began reimbursing physicians for remote patient monitoring services under a separate billing code. However, Verma noted that home health providers were excluded from that change.

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The agency also included a request for information about the possibility of making interoperability mandatory for long-term care facilities by building it into Requirements for Participation (RfP) for Medicare reimbursement. The agency made a similar request in April in a hospital payment proposal, which the American Hospital Association (AHA) strongly opposed. In its comments, the AHA pointed specifically to the postacute care sector as being behind the curve with EHR adoption.

However, a group of more than 50 ACOs, insurers and IT groups came out in support of the measure.