Remote patient monitoring and chronic care management are relative newcomers to the healthcare stage. The Centers for Medicare and Medicaid Services began offering reimbursements to providers for chronic care management services in 2015 and added RPM reimbursement a few years later in 2019. Since then, CCM and RPM programs have seen steady growth, and even accelerated since Covid in 2020 created a surge in demand for telehealth services.
Just how much have these programs changed the healthcare landscape? Let’s look at a few statistics:
- Nearly 9 in 10 providers are looking for ways to increase patient involvement in managing their chronic conditions.
- 94% of healthcare executives say that RPM improves patient outcomes.
- 79% say that CCM has a positive impact on care.
- 88% of hospitals and healthcare systems have invested or plan to invest in RPM.
- The RPM industry has tripled in size since 2022 and predicts a compound annual growth rate of 18.6% over the next six years.
- RPM CPT Code 99454 was billed more than 1.2 million times in 2022, an increase of 41% over 2021.
- CCM CPT Code 99490 was billed more than 4.5 million in 2022, an increase of 5% over 2021.
Patient Outcomes Improve with CCM and RPM
CCM and RPM have proven again and again that they are effective, clinically significant interventions. Studies show improvements across many different provider types for a wide variety of chronic illnesses. The benefits for patients are significant and life-changing:
- RPM can reduce hospital readmissions for heart patients by up to 50%.
- RPM patients show improved blood pressure control and reduced systolic BP.
- CCM interventions improve glycemic control for patients with diabetes.
- COPD patients who receive CCM services show fewer hospitalizations and ED visits as well as shorter length of stay compared with those who don’t.
- CCM improves medication adherence and reduces cost burdens for patients.
The Financial Benefit for Practices
In addition to the health benefits of CCM and RPM, the programs have also made it possible to reduce overall healthcare costs and increase practice revenue. In one survey, 17% of healthcare organizations reported cost reductions with a CCM program. Those numbers skyrocket when you consider the compounding costs of a hospital stay and the reduction in admissions as a result of CCM and RPM.
The potential for increased revenue is another reason to implement 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
With high program enrollment and consistent servicing, this translates into significant new profit streams for practices.
Achieving those results, however, depends on effective program management. This includes establishing a reliable patient enrollment strategy, maintaining participation in the program over time, and delivering quality care that ensures improved patient outcomes.
Most practices lack the time and resources to do all these things on their own. That’s why partnering with a third party CCM and RPM provider like HealthXL makes both financial and clinical sense. Our care coordinators are uniquely trained to deliver high-quality, compassionate patient care, and our enrollment specialists achieve enrollment rates above 40%.
If you’re ready to experience better outcomes, higher profitability, and improved patient retention in your CCM and RPM programs, we can help! Schedule an appointment to talk to one of our specialists today and see how CCM and RPM can transform your practice.