By: Neil Nair, MD
Remote patient monitoring uses digital technology to collect medical data from users and transmits the same data to providers in a real time manner. This has proven to reduce hospitalization, reduce ER visits and improve patient outcomes. During Covid-19, patients have reported a sense of safety and increased patient satisfaction using remote patient monitoring technology to address their health needs.1
Traditionally, for services furnished in a physician’s office, CMS makes payments to provider/physicians and other healthcare professionals at a single rate based on the full range of resources involved in furnishing the service. Payments are based on the relative resources typically used to furnish the service. Relative value units (RVUs) are applied to each service for physician work, practice expense, and malpractice. These RVUs become payment rates through the application of a conversion factor. Payment rates are calculated to include an overall payment update specified by statute.
2022 Fee Schedule-
Recently, CMS introduced the 2022 physician fee schedule (PFS)2, which will reduce physician pay next year. The calendar year (CY) 2022 PFS proposed rule is one of several proposed rules that reflect a broader Administration-wide strategy. Some of the highlights of this proposal are:
- Decreasing the 2022 physician pay conversion factor 3.75 percent next year, from $34.89 to $33.58. The adjustment would consider for changes in the relative value units and expenditures to other proposed policy updates.
- CMS has noted that Congress has proposed budget neutrality updates that will account for Relative value units (RVU) changes, and the 3.75 percent payment increase from the Consolidated Appropriations Act of 2021, part of the Coronavirus- related legislation, which is set to expire at the end of the year.
CMS Fee Schedule Rationale-
The primary goal of CMS from this revised payment schedule is seeking more health equity- accessibility, quality, affordability, empowerment, and innovation like telehealth, remote patient monitoring utilization for physicians. CMS has stated that they have seen large health disparities among Medicare beneficiaries during the public health emergency crisis from COVID-19. CMS has resorted to innovative policy changes to reduce these disparities among the population. However, there has been significant backlash from physician groups around the country. Physicians have pointed out that these fee schedules have not considered the current inflation rates. This would significantly increase the burden on their existing resources and impact adversely on quality of care and patient outcomes.
Covid-19 has brought an increased burden on physician practices from a revenue standpoint. Expenses of disposables, disinfectants, HVAC filters and other precautionary measures, for bringing patients through the door, have significantly impacted their bottom line. Now with the reduction in the payment schedule, physician practices are looking to either consolidate with other practices, with medical groups or close doors to their practices permanently.
Med-kick, a Remote patient monitoring company, with primary focus on patient outcomes, helps physicians take on the additional burden of clinical monitoring, for chronic care management (CCM), Remote Patient Monitoring (RPM), Principal care Management (PCM), at no additional cost to these practices. By partnering with Med-kick, physicians are able to bring extra revenue to their practices, thus making up for the loss of revenue from the new CMS fee schedule. They can focus entirely on patient outcomes without worrying about any added costs, in the midst of reimbursement cuts.
- Annis, T., Pleasants, S., Hultman, G., Lindemann, E., Thompson, J. A., Billecke, S., … & Melton, G. B. (2020). Rapid implementation of a COVID-19 remote patient monitoring program. Journal of the American Medical Informatics Association, 27(8), 1326-1330.
- Centers for Medicare & Medicaid Services. “Medicare Program; CY 2021 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies.” Fed Reg 85.248 (2020): 84511-84516.