How remote patient monitoring made its way into Medicare’s 2018 reimbursement rules
As announced in the final rule in November, starting in 2018, a new reimbursable Improvement Activity is being added to the Centers for Medicare and Medicaid Services' Merit-based Incentive Payment System (MIPS), which encompasses using digital tools to monitor patients outside the hospital. Three digital health companies that worked with the CMS to bring about the change weighed in today on the news.
“Patient-generated health data is a valuable tool in patient care,” Anne Weiler, cofounder and CEO of Wellpepper said in a statement. “We’re pleased that CMS has recognized this, and is enabling the collection and analysis to be used in demonstrating quality patient care.”
MIPS is a part of the CMS Quality Payment Program created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). It allows eligible physicians to receive payment adjustments by reporting performance around the four categories of quality, advancing care information, cost, and improvement activities. This was the first year of the program and the guidelines are being tweaked for next year.
To report improvement activities, physicians must choose from a list of 93 activities. The new one in question is “Engage Patients and Families to Guide Improvement in the System of Care.” It will encompass remote monitoring as well as reviewing and interpreting patient-generated health data, provided the physician uses clinically-endorsed tools that include an active feedback loop. That means the system has to return some kind of actionable information to the patient or care team.
“It's not enough to want providers to expand care beyond the four walls of the office, it’s about empowering consumers and updating all parts of the system,” Michael Sturmer, Livongo's SVP of health services, said in a statement. “The new CMS MIPS Improvement Activity further connects digital health with providers and care practices and is a significant advancement in making digital health part of the fabric of the healthcare experience. It is better for patients and providers, and that's better for all of us.”
Wellpepper, a provider of personalized, digital treatment plans; HealthLoop, which makes a care coordination system that helps physicians automatically check in with their patients; and Livongo, a chronic condition management company starting with diabetes management, all lobbied CMS for the change and were also involved in a recent CMS roundtable on patient-generated health data.
The three companies authored and submitted the proposal to CMS in February, according to a blog post by HealthLoop CMIO Ben Rosner, who says he originally came up with the idea.