Patient Data Access News

CMS Proposal Adds Remote Patient Monitoring in Home Health Payments

CMS has updated a home health payment rule to incentivize remote patient monitoring technology use.

CMS remote patient monitoring

By Sara Heath

- CMS has proposed changes to the Home Health Prospective Payment System that would incentivize home health providers to utilize remote patient monitoring devices and improve patient-centered care.

In an announcement earlier this week, the agency stated that these changes will advance its efforts to put patients over paperwork and prioritize value-based care.

“Today’s proposals would give doctors more time to spend with their patients, allow home health agencies to leverage innovation and drive better results for patients,” CMS Administrator Seema Verma said in a statement. “The redesign of the home health payment system encourages value over volume and removes incentives to provide unnecessary care.”

Specifically, CMS proposed to allow home health providers to include remote patient monitoring tools as an allowable Medicare cost. This means providers could be compensated for using some remote patient monitoring technologies, making a financial case for the patient engagement tools.

CMS defined 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 to the [home health agency],” CMS wrote in the proposed rule, which has been published in the Federal Register.

Per the CMS MyHealthEData Initiative, home health agencies will be expected to conduct extensive care planning with these remote patient monitoring tools. Additionally, they will be expected to facilitate free data exchange between patients and other providers not affiliated with the home health agency.

The proposed changes would also implement a transitional payment program for home infusion services. Beginning in calendar year 2019, home health providers could take advantage of a separate Medicare benefit category for home infusions.

Covered services would include associated professional services for administering certain drugs and biologicals through a durable medical infusion pump, training and education, and remote monitoring and monitoring services effective January 1, 2021, CMS said.

Allowing Medicare patients to receive more care and treatment from the comfort of their homes may have a positive impact on patient satisfaction and quality of life. Research indicates that more patients want to age in their own homes, rather than receive complex treatment inside of a medical facility.

Remote patient monitoring makes that preference possible by allowing clinicians to track important patient metrics from afar. When a patient does need in-person medical attention, remote patient monitoring devices typically alert the clinician to the issue, making care seamless for patients.

Other proposed changes aim to put the patient at the center of care, CMS reported in the proposed rule. A new Patient-Driven Groupings Model (PDGM) would do away with a “therapies threshold” for care when determining Medicare payment. It would also change the unit of payment to 30-day intervals instead of 60-days.

This approach will make home care more patient-centric and value-based, CMS said. Instead of paying for individual services, it eases home care into the transition of outcomes- and value-based payment models.

The proposed rule also aims to reduce administrative burden for home health providers as well as referring providers. Specifically, the rule will eliminate the need for referring providers to determine how much longer skilled services are needed.

Reduction of administrative burden will help providers spend more time with their patients building relationships. Those ideals align with the agency’s “Patients Over Paperwork” priorities to drive patient-centered rather that bureaucracy-driven care.

CMS is currently issuing a Request for Information about the proposed rule to integrate industry feedback into the policy.

Specifically, the agency is looking for feedback about patient health and safety standards for stakeholders involved in patient transitions of care. This would amend the Conditions of Participation that could improve interoperability between various providers that are a part of a Medicare beneficiary’s care plan.

CMS will be accepting public comment via either digital submission or mail by August 31, 2018.


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