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RPM Payments & Reimbursement

As with all forms of telehealth, reimbursement is an important component of remote care. Find out who pays for RPM (and why) in this course.

5 lessons 10 minutes free course

Course Description

As with any aspect of telehealth, reimbursement is an important topic with remote patient management. Who pays for it? How does it work? What role do Medicare, Medicaid and private insurers play — and how is that likely to change in the years to come? These are essential questions, and in this course from the RPM Academy, you’ll learn the answers to them — along with a few other important items about telehealth reimbursement.

Course Outline

  • Who Pays For Remote Patient Management Programs?2:38

    Who pays for remote patient management? Increasingly, it's the "organizations that either carry financial risk, or are driving quality improvements," according to our experts. This includes insurance companies, hospital systems, specialty clinics, and similar groups. In this video, you’ll learn just who pays for RPM programs, and why it's increasingly seen to be in their best interests to do so.
    In this lesson, you will learn:

    • Who covers RPM payments, and why
    • Why organizations that carry financial risk are likely to invest
    • Why groups looking to drive improvements invest in RPM
    • How RPM drives down utilization costs'

  • Does Medicaid or Medicare Pay for Remote Patient Management?2:18

    When it comes to RPM, Medicare and Medicaid offer differing levels of reimbursement, depending on the services offered, the location where care takes place, and a variety of other factors. In this lesson, our experts discuss recent developments that may lead to new standards of CMS reimbursements for RPM across the U.S., and predict how this trend is likely to evolve in the years to come.
    In this lesson, you will learn:

    • Why lawmakers are pushing to change RPM reimbursement
    • Why individual states are redefining their own models
    • The role of location-based restrictions in reimbursement
    • Why RPM is considered an "alternative payment model"

  • Do Private Insurance Plans Cover Remote Patient Management?1:21

    More private insurance plans are choosing to pay for remote patient management, particularly Medicare Advantage and other at-risk entities, as our experts explain in this lesson. And the reason for this isn’t difficult to understand: Remote care has been shown to have a direct impact on cost control and quality of care, with clinical results that demonstrate a potential to lower costs and improve health outcomes.
    In this lesson, you will learn:

    • Why some private insurers cover RPM
    • Some of the benefits RPM offers payers
    • How remote care impacts costs
    • How remote care impacts quality of care

  • How Does RPM Benefit Payers?2:12

    How does RPM benefit the groups that pay for it? The constant monitoring offered by remote care can lead to early detection of serious events, helping reduce expensive emergency room visits and hospital readmissions. And because health plan members tend to feel more engaged and satisfied with quality care at home, RPM can also increase member satisfaction and loyalty, helping to improve payer quality scores, too.
    In this lesson, you will learn:

    • How RPM reduces costs by driving utilization
    • Why RPM is particularly effective for higher-risk patients
    • How RPM can increase member satisfaction and loyalty
    • How RPM can improve payer quality scores

  • Will Reimbursements Continue to Improve?1:39

    Every year, RPM reimbursement expands to include new conditions and new geographical areas. Mississippi, for example, has become a pioneer in RPM reimbursement thanks to the success of the Mississippi Diabetes Telehealth Network. In this lesson, our experts discuss some of the recent progress made in RPM reimbursement and why that trend is likely to continue given remote care’s role in value-based care.
    In this lesson, you will learn:

    • Why recent legislation seeks to expand access to RPM
    • The role of RPM in the shift to value-based care
    • Why Mississippi has become a RPM pioneer
    • Why RPM expansion holds bipartisan appeal

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