CMS proposes reimbursing home health agencies for remote patient monitoring

The Centers for Medicare and Medicaid Services on Monday announced a proposed rule to allow home health agencies to be reimbursed—for the first time under Medicare—for remote patient monitoring.

CMS made the rule proposal as part of a broader package of changes to the Home Health Prospective Payment System meant to empower patients, increase competition and foster innovation.

“We are proposing to modernize Medicare to promote innovation and improve home health by increasing access to remote patient monitoring,” said CMS Administrator Seema Verma during a call Monday announcing the rule. “This will allow patients to share more live-time data with their providers and caregivers, which will lead to more tailored care and increased positive health outcomes.”

Verma pointed out that last year, CMS made changes to enable physicians to bill for services related to remote patient monitoring to leverage technology to help track patents’ clinical data such as weight, blood pressure and heart rate. However, home health agencies could not bill for these services, she added.

Now, CMS is proposing to define remote patient monitoring in regulation for the Medicare home health benefit and to include the cost of remote patient monitoring as an allowable expense documented on the home health agency cost report for reimbursement.

“In today’s proposal, we address that disparity to make sure home health agencies can leverage innovation to provide state-of-the-art care,” according to Verma. “Specifically, we are proposing to include the cost of remote patient monitoring as an allowable administrative cost. This will allow home health agency payment to reflect their use of innovative technology.”

In addition, she said CMS is reducing burdens by eliminating duplicative and unnecessary recertification requirements, while focusing quality measures on those that actually track positive health outcomes.

“This rule continues our Meaningful Measures Initiative by removing seven measures from the Home Health Quality Reporting Program that were either unnecessary or were topped out,” Verma said. “None of the measures we are eliminating will reduce transparency or patient safety.”

The burden reduction as a result of the Home Health Quality Reporting Program and other proposed changes are estimated to result in a net annualized cost savings of $60 million for home health agencies, noted Verma.

“Physicians who order home health services for their patients would also see administrative burden reduced, as we are eliminating the requirement that certifying physicians estimate how much longer skilled services are needed when they recertify the patient’s need for continuing home healthcare,” she said. “This information is already gathered on a patient’s plan of care, so the existing requirement is redundant.”

“We are fully committed to achieving interoperability, and we’re asking stakeholders to give us their ideas on how we can achieve it,” she concluded. “We are doubling down on our efforts here because there is no reason why in the year 2018 patients shouldn’t have access to their medical records and the ability to share those records with whatever provider they choose.”

CMS is accepting comments on the proposed home health rule until August 31. A fact sheet on the proposed rule is available here.