COVID-19 accelerated the shift to move care outside the four walls of the hospitals.
Pre-pandemic, hospitals and providers were slowly embracing patient-centric care models that allowed patients to receive care whenever and wherever they need it. When COVID-19 hit, providers had no other choice but to treat patients with chronic conditions such as COPD, diabetes, and hypertension remotely.
The floodgates are now open for remote patient monitoring (RPM) as patients embraced the ease and convenience of not having to go to the doctor’s office.
How can RPM vendors capitalize on this market opportunity to get their healthcare technology in the hands of the right patients and providers?
Finding patients who would benefit from RPM technology
Ultimately, RPM technology needs to get in the hands of patients if it is to improve outcomes and aid in keeping people healthy at home. Before you can get a RPM solution in the hands of a patient, you first need to understand who your potential patient population is.
To do that, you’ll want to leverage insights from medical claims data. Both diagnosis and procedure codes can aid RPM vendors in understanding the total addressable patient population for their solution.
Diagnosis and procedure codes for chronic condition management
Typically, RPM solutions can aid with chronic condition management. To find patients with chronic conditions, RPM vendors can use medical claims data to learn what patients have been diagnosed with a specific condition. Conditions such as hypertension, hyperlipidemia, diabetes, and chronic obstructive pulmonary disease (COPD) top the list of diagnoses each year according to our medical claims database.
The procedure data captured in medical claims can also help RPM vendors understand patients with chronic conditions. For example, CPT code 99490 is used for chronic care management services. In 2020, physicians billed for chronic care management services over two million times according to data in our medical claims database.
Finding providers who should be leveraging RPM tools
Once you’ve identified the potential patient populations, you’ll want to understand what physicians are treating these patients and if they’re leveraging RPM tools already.
Procedure codes in medical claims can provide incredibly valuable insights to RPM vendors on who is and isn’t using RPM today.
CPT Codes for RPM
Over the last few years, CMS has slowly introduced more codes specific to remote patient monitoring services. CPT codes 99453, 99454, 99457, and 99458 are currently the main codes tied to RPM activities.
With a platform like Definitive Healthcare, you can measure volumes for these codes and gain insights on what physicians and healthcare facilities are currently billing for these services. Once you understand who is already billing for these types of services, you can identify providers with a similar patient population who could benefit from deploying RPM tools.
Leveraging readmissions data for RPM
Outside of procedure codes, readmissions data can also help RPM vendors identify providers and healthcare facilities that could potentially benefit from deploying RPM tools. Facilities with a high readmission rate for a condition your RPM solution can manage would be great targets for your sales efforts.
For example, according to our data the national COPD readmission rate is 17.5% based on the 2019 Medicaid claim year. If you’re an RPM vendor with a solution that aids with the management of COPD, understanding what hospitals have a higher readmission rate than the national average can help you determine where to focus your sales efforts.
Making the case for deploying RPM tools
Now that you’ve identified the potential patient population, found the providers and healthcare facilities to target, you’ll need to make the case for why they should deploy a RPM solution.
Providing market context can help your sales team refine and personalize your go-to-market messaging so it resonates with the providers or executives in charge of purchasing your solution.
Prove the ROI for RPM with readmission data
In addition to helping you identify a provider or facility to target, readmission data can also bring valuable context into your sales conversations. As value-based care models grow in popularity, the ability to reduce readmission can be a great way to prove the ROI of your product as physician reimbursement is tied to quality metrics. Understanding an organization’s current readmission performance arms your sales team with the insights needed to show how your RPM solution can improve healthcare outcomes and increase their financial performance.
Demonstrate potential revenue opportunities for RPM
In healthcare, reimbursement tends to be a major barrier to new technology adoption. By leveraging medical claims data, RPM vendors can show the potential revenue streams available to providers who might be hesitant to bite the bullet in investing in a RPM solution.
With access to our medical claim database, Definitive Healthcare users can see the total charges for a procedure as well as the average charge per procedure. This information can be valuable to bring to sales conversations to show the potential revenue opportunities for each of the CPT codes for RPM activities.
Whether you need to understand which physicians are leveraging RPM tools, segment the total addressable market, or identify the reimbursement opportunities tied to RPM service, Definitive Healthcare has got you covered.
With insights on over 9,100 hospitals and IDNs and access to all-payor claims information for 315 million U.S. patients, Definitive Healthcare can amplify your sales and marketing efforts to stand out in the growing RPM space.
Request a free trial to see how we can help you meet your RPM goals today.