Remote Physiological Monitoring Improves Patient Access, Care, and Revenue

Remote physiological monitoring (RPM), especially for patients with cardiometabolic conditions, may improve patient care and increase revenue, but not without initial investments, a new study reported in Health Affairs.1

RPMs send physiologic measures, such as blood pressure, to the patient's care team via cellular or Bluetooth-enabled devices. While this innovation has been shown to relieve provider burden and improve patient access to adequate medications, it requires a costly initial investment.1,2 Since the CMS began covering RPMs, the providers billing for RPM services increased, with the majority concentrated in primary care. These services included initial patient onboarding, monthly device provisions, and care team time spent using the data to manage care. While prior research has examined RPM in clinical practice, researchers aim to identify the effects of RPM on the practices themselves.1

Remote physiological monitoring may improve patient care and practices' revenue. | Image Credit: @AndSus-stock.adobe.jpeg

In an interview with The American Journal of Managed Care® (AJMC®), Anitha Vijayan, MD, senior medical director at Intermountain Kidney Service and Nephrology at Intermountain Health, emphasized the impact RPM would have on patient access.2

“A lot of patients have relied on their spouses or their children to take off work so they can bring them in. Now we're affecting somebody else's time as well,” she said. “[With that said,] patients who have significant challenges coming to see us in person will benefit from telehealth visits.”

Remote Physiological Monitoring in Clinical Practice

The study used Medicare claims submitted from 2017 to 2023 and limited its analysis to primary care practices. The analysis’s criteria required practices to have substantial care activity throughout the allotted time period and focused solely on primary care. The primary analysis included primary care centers that adopted RPM between 2017 and 2021.1

The study authors predicted that RPM adoption would encourage practices to prioritize RPM patients insured by Medicare at the expense of other patients. However, the results did not show that high RPM propensity diminished care or access for other patients.

The primary analysis included 754 primary care practices that adopted RPM between 2017 and 2021. After adoption, RPM usage increased, becoming a significant pillar in multiple practices, accounting for a mean of 12.4% of revenue from traditional Medicare coverage.

Of the 754 practices included, 98.1% (n = 740) were matched to 2,215 control practices, and the remaining 1.9% (n = 14) of practices could not be matched. RPM-adopting practices saw a 20% increase in revenue (95% CI, 16.1-23.8; P < .001) when compared with matched control practices. Aside from the surge in RPM billing, other care management and coordination services and telemedicine visits also contributed to the increase in revenue.

Adoption of RPM also increased the practices' patient panel size. Practices saw 2.9% more patients each quarter (95% CI, 1.0-4.7; P = .002) and completed 4.3% more outpatient visits (95% CI, 1.0-7.4; P = .010).

Increase in Accessible, Equitable Primary Care

Of the 740 primary practices and 2,215 matched control practices, there were a combined 877,708 patients that met continuous enrollment criteria. Patients were assigned scores reflecting their likelihood to use RPM based on the study’s propensity model. Consistent with prior research, those most likely to use RPM were more likely to be non-White, be dually eligible, and have a higher disease burden.

Researchers observed an increase in primary care visits for patients with a high RPM propensity at RPM-adopting practices. More specifically, the prevalence of high-propensity patients increased by 3.8% (95% CI, 2.0-5.6; P < .001) in primary care visits.

The study authors suggest that Medicare’s reimbursement of RPM services can expand care provisions, especially for patients with high-risk diseases and conditions and historically underserved populations.

Cost of Implementing Remote Physiological Monitoring

At Intermountain Health, their goal is to reduce hospitalizations with RPM, especially for those with high-risk and expensive diseases, Vijayan said. Although RPM has been shown to increase revenue for primary care practices, the initial investment is expensive.1,2 Vijayan estimated start-up fees for RPM to be $20,000 or more.2

“Doing a tele-visit, especially if you're doing it from a phone plan and stuff, there's a charge for that data,” Vijayan said, describing additional costs patients would have to bear to access RMP.

Vijayan proposed further shifting the cost onto the patient, for example, asking patients to buy their own blood pressure monitor and self-report those findings back to their primary care provider. 2 In addition to the cost of resources, practices would need to hire staff to accommodate the influx of data, which would further hinder physician productivity and workload.1

“As the patients report blood pressures, our nurse navigators are the first to review that data, and they will, in turn, discuss it with our physicians or the APS to address appropriate management,” Vijayan said, describing the system Intermountain Health implemented to accommodate the surplus of data due to RPM.

Insights into Medicare claims for RPM's impact on primary care practices advance the current understanding; however, the study was still limited as it only analyzed traditional Medicare claims. Thus, it limits the generalizability to patients insured by other payers. Furthermore, researchers were unable to view unbilled RMS services that did not meet the billing threshold.

“Future work should investigate this further and examine the interplay between investments in new technology and support staff and their combined effects on provider productivity and care access,” the study authors concluded.

References

1. Tang M, Stern AD, Marcondes F, Mehrotra A. Practices that adopted remote physiologic monitoring increased Medicare revenue and outpatient visits. Health Aff. 2025;(44):11, 1386-1394. doi:10.1377/hlthaff.2025.00683

2. McCrear, S. Remote monitoring may improve heart failure outcomes with Anitha Vijayan, MD. AJMC. Published October 31, 2025. Accessed November 4, 2024. https://www.ajmc.com/view/remote-monitoring-may-improve-heart-failure-outcomes-with-anitha-vijayan-md