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Provider Adoption of Remote Patient Monitoring Lags Due to Poor Reimbursement, Pricing Issues

December 17, 2015
by Heather Landi
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While interest in remote patient monitoring is high, the market is still in its infancy and most healthcare providers are waiting until there is a better reimbursement climate for connected health models, which is still several years away, according to a new report from Boston-based Chilmark Research.

“One thing is clear – the vision of an entire population of patients, young and old, high-risk and healthy, equipped with monitors that send data seamlessly into an efficiently managed healthcare system – remains science fiction given where technology and the market are today,” Chilmark Research writes.

In the report, entitled Migration to Connected Health: Opportunities and Challenges in Remote Patient Monitoring, Chilmark Research focuses on asynchronous, device and data-driven approaches to improve medical care such as remote patient monitoring and web/mobile software apps.

Driven by the shift towards value-based models of care, approaches such as multi-sensor remote monitoring kits and medication reminder apps are garnering new interest from healthcare organizations striving to avoid the costs of delivering in-fa­cility care, the research firm notes in the report.

“Though connected health models make sense for patient care, their adoption among healthcare providers has his­torically lagged due to poor reimbursement by both public and private payers,” Chilmark Research writes. “The market opportunity for these new models is the result of both the shift towards value-based reimbursement for care providers and the growing costs of chronic disease care.”

However, despite broad interest in these new models of care, the connected health market “is in its very early stages of maturity” as “there are no standard customers and there is a high degree of variation among vendors,” Chilmark Research writes.

“We have found little uniformity in application/use cases even within the context of a single disease state, and even less so in terms of monitoring a large, chronically ill population. As a result, price points and pricing models also vary widely.”

In the report, Chilmark Research focused on the provider market for connected health models and the report cites numerous healthcare provider organizations – Partners Healthcare, Geisinger Health, Mercy, Sharp and Banner – that have demonstrate financial and clinical success by leveraging connected health models.

However, today’s prominent buyers are still health insurance organizations, the report states. “This makes sense given where the financial risk falls in today’s payment landscape,” Chilmark Research writes.

And, the research company predicts that the shift to provider-dominated purchasing of connected health models is still several years away.

“Outside of the small pack of large provider systems innovating, the average health system or small hospital will simply wait until there is a better reimbursement climate,” Chilmark Research states, adding that such an environment will likely emerge closer to the end of the decade due to a number of factors. First, more than 10 states have updated Medicaid reimbursement for remote monitoring and this trend is likely to continue. Also, the meaningful use program Stage 3, proposed to begin in2018, carries proposals for mandatory collection of patient-generated health data (PGHD) in the electronic health record (EHR), which could motivate the EHR industry and the provider market to build out the foundational elements of connected health models, Chilmark Research writes.

The research company predicts that provider adoption will ramp up in concert with the adoption of large, value-based contracts, while health plans, large, self-insured employers and more progressive health delivery systems will continue to invest in connected health models to update disease management programs around diabetes, hypertension, asthma or other specific areas.

While the promise of connected health models, namely, their potential to improve cost-savings and reduce hospital admissions, is well understood, the conversation is now shifting to the specific conditions for their success, such as reimbursement models, pricing issues and workflow optimization.

Chilmark Research writes that healthcare provider organiza­tions should feel comfortable taking a “wait and see” approach but also suggests that organizations should “dip a toe into these waters.”

In the report, Chilmark Research points out that healthcare consumers will increasingly come to expect the incorporation of connected health devices in their care. At the same time, companies like Walgreens have made tremendous progress in the area of connected health models, which raises the bar on consumer expectations and might indicate Walgreens angle to play a deeper role in managing population health.

The research report offers a number of insights and recommendations for healthcare providers exploring connected health models. Chilmark Research suggests providers pick a best-of-breed vendor offering device-agnostic, flexible approaches to connected health.

“The connected health vendor you choose will be more than a supplier – they will serve as your strategic partner. Due diligence beforehand is critical,” the report states.

Also, healthcare providers should educate clinical staff on the goals, benefits and details of any connected health program being implemented. Chilmark Research also recommends providers recruit members of the frontline staff to play a part in the patient enrollment process.

“Staff buy-in is critical. This means empowering department leadership to do as they see fit, whether that means changing a certain workflow or leaning less or more heavily on a vendor for certain tasks. The program should fit cleanly into other initiatives, whether that is an existing disease management program or a discharge planning process,” the report states.

Finally, ongoing cost-benefit analysis is essential to producing value from a connected care program, Chilmark Research writes.

 

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