The digital health ecosystem continued to explode in 2018, with an influx of new investment dollars and hundreds of vendors offering wide-ranging solutions. We also saw heightened recognition by the Centers for Medicare and Medicaid (CMS) of digital health innovations as proven tools to support high quality, convenient care.
As 2018 comes to a close, we’re taking a look back on highlights from the year at GetWell Loop and what we expect in 2019.
In November, we made headlines with the announcement that patient engagement pioneer GetWellNetwork acquired HealthLoop. In response to the expectations of today’s digital consumer, GetWellNetwork was drawn to HealthLoop’s expertise in mobile technology and digital care management.
Over the coming months, the two companies will work together to develop an integrated solution called GetWell Loop. The solution fills the post-discharge follow-up gap and unifies the pre- to post-care patient experience by bringing together the key elements of convenience and coordination frequently missing from traditional care delivery.
Located in Bethesda, Maryland, GetWellNetwork will rely heavily on HealthLoop’s digital tools as the industry continues its transition toward patient-friendly digital health. Modules from the company’s GetWell Go, the analogue to the HealthLoop platform, will augment our platform with functionality and language globalization that we haven’t had until now. The partnership expands GetWellNetwork’s reach and brings HealthLoop’s tools to international markets.
It is a logical partnership. The two companies share a similar strategy, values, and culture. I am looking forward to working together to push the boundaries of connected health.
Virtual care reimbursement gains momentum
Historically, one of the biggest challenges to health systems and providers adopting new digital tools has been the lack of reimbursement for virtual care and remote patient monitoring (RPM).
These hurdles are beginning to fall, however.
As we’ve highlighted previously on the blog, CMS made remote patient monitoring a separately payable service when it unbundled and activated CPT code 99091 in the 2018 Physician Fee Schedule. Beginning last January, providers can be reimbursed for time spent collecting and analyzing health data that is generated by a patient, digitally stored and transmitted to the providers.
Also new this year, eligible clinicians participating in the Quality Payment Program can now be reimbursed for digital tools that collect patient-generated health data. These tools include “patient engagement and outcomes tracking platforms, cellular or web-enabled bi-directional systems and other devices that transmit clinically valid objective and subjective data back to care teams.”
When CMS included several new billing codes in its final Medicare Physician Fee Schedule for 2019, RPM reimbursement took another step forward. Overall, we feel these latest changes are good, but not great. The Final Rule provides more opportunities for physicians to get paid for using technology in their practices, but barriers still exist that could hamper widespread adoption.
In a nutshell, beginning in January, providers can now be reimbursed for addressing a question or concern from a patient through a virtual check-in to determine whether an office visit is needed. Medicare beneficiaries will still have to pay their out-of-pocket portion of the expense, which means that patients could receive a bill for $2 per interaction. I have concerns about this decision, as it could create barriers for patients seeking care. CMS has also imposed time restrictions that these cannot be billed in the seven days following an in-person visit or within 24 hours of another in-person visit. This requirement also seems to further limit impact for both providers and patients.
Another new code allows physicians to get paid for the evaluation of photos and videos of symptoms uploaded from smartphones. Finally, CMS has expanded its parameters to allow clinical staff time to be reimbursed for remote patient monitoring. Further, CMS has lowered the timeframe from 30 minutes to 20 minutes per patient per month.
The road ahead for patient engagement
On the reimbursement front, we are pleased that CMS is beginning to recognize that digital health technologies can play an important role in ongoing care. We hope CMS will continue to broaden the scope of reimbursement for remote patient monitoring services as the evidence mounts in favor of these digital health tools.
Financial incentives aside, on a daily basis, we see first-hand from our customers the important role virtual care and RPM services play in keeping patients engaged, informed and supported throughout their care experience. Meaningful patient engagement is a game-changer; it saves lives, reduces complications, improves access and lowers cost.
Looking ahead, patient engagement promises to gain even more momentum in the coming years. Technology solutions are becoming more sophisticated as consumer expectations for digital health rise. Companies increasingly recognize that patient experience isn’t confined to the four walls of the hospital and are moving to engage patients at home and across the care continuum.
As such, I expect to see continued consolidation in the industry, as patient engagement vendors partner to develop end-to-end solutions that address patients’ wide-ranging needs.
This coming year, we look forward to working with GetWellNetwork to expand our reach and improve the health and wellbeing of even more patients. We are thrilled to offer new solutions to our current customers and establish relationships with new ones.
From all of us at GetWell Loop, we wish you and your loved ones much health and happiness in the New Year.