The Top Reasons 90% of Providers Are Embracing CCM and RPM Programs

Telemonitoring and Chronic Care Management are two relatively new players in the healthcare stage. The Centers for Medicare and Medicaid Services started reimbursing providers for Chronic care management services in 2015 and introduced RPM Reimbursements a couple of years later in 2019. Since then, CCM and RPM programs have continued to experience growth at an increased pace since Covid in 2020 increased the demand for telehealth services.

To what extent, then, have these programs altered the delivery of healthcare? Let’s look at a few statistics:

• A somewhat surprising finding was that nearly 9 in 10 providers are seeking strategies to engage patients in managing their chronic diseases.
• Globally 94% of healthcare executives argue that RPM enhances positive patient outcomes.
• 79% of the respondents opine that CCM has a positive effect on care.
• Currently, 88% of hospitals and healthcare systems have invested, or intend to invest in RPM.
• The RPM industry has grown threefold since 2022 and is expected to have a compound annual growth rate of 18.6% in the next six years.
• Of the new codes introduced in 2022, RPM CPT Code 99454 was billed more than 1.2 million times in 2022, up 41% from 2021.
• The CPT Code 99490 CCM was billed more than 4.5 million times in 2022, up from 2021 by 5%.

Enhance Patient Outcomes with Chronic Care Management and Remote Patient Monitoring

CCM and RPM have been shown time and time again to be efficacious, clinically relevant interventions. Research indicates positive changes in satisfaction with numerous types of providers for numerous chronic diseases. The benefits for patients are significant and life-changing:

• RPM can cut hospital readmissions among heart patients by as much as 50%
• RPM patients will have better blood pressure management and lower systolic BP.
• CCM interventions enhance the glycemic control of patients with diabetes.
• Our analysis revealed that COPD patients who utilized CCM services had lower levels of hospitalization and ED visits as well as reduced length of stay compared to those who did not.
• CCM enhances patient compliance with prescriptions and decreases the financial impact of medicines on patients.

Financial Advantages for Medical Practices

Besides the health impacts of CCM and RPM, the programs have enabled one to achieve the intended goal of inexpensive general healthcare charges and improved practice revenue. One survey has shown that 17% of healthcare organizations have noted the cost reduction with the CCM program.  Those numbers are even higher when looking at the cumulative costs of a hospital stay and how many fewer admissions are made due to CCM and RPM.

Another argument is the possibility to increase revenues owing to the realization of these programs. National average monthly reimbursement rates per patient are:

• CPT Code 99490 (CCM): $62.58
• CPT Code 99454 (RPM): $47.27
• CPT Code 99457 (RPM): $48.93

High program enrollment and servicing frequency mean this translates to new profit streams for practices in the millions.

To get those results though the management of the program in question is crucial. This entails the identification of a stable patient enrollment plan, retention in the program over time and provision of quality service that enhances the overall potential of the patient.

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