I have blogged previously about the growing decentralization in healthcare with an increasing number of services provided away from hospitals and with movement toward consumer homes (see: TEN MAJOR TRENDS FACING THE HEALTHCARE INDUSTRY IN THE AMBULATORY SPACE ON A FIVE-YEAR HORIZON; Mobile Health Teams as a Variant on the Theme of Decentralized Acute Care in the Home). New technology is providing cost-effective and useful solutions in terms of home monitoring devices (see: Top 10 Remote Patient Monitoring Companies for Hospitals).
A key element in the success of new ways to deliver healthcare has always been whether reimbursement for new models of care is available. CMS has proposed changes to the Home Health Prospective Payment System that would provide incentives for the use of remote monitoring devices (see: CMS Proposal Adds Remote Patient Monitoring in Home Health Payments). Below is an excerpt from a recent article on this topic:
In [a recent announcement]..., the agency stated that these changes will advance its efforts to put patients over paperwork and prioritize value-based care....Specifically, CMS proposed to allow home health providers to include remote patient monitoring tools as an allowable Medicare cost. This means providers could be compensated for using some remote patient monitoring technologies, making a financial case for the patient engagement tools. CMS defined remote patient monitoring as “the collection of physiologic data (for example, ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the [home health agency]....Allowing Medicare patients to receive more care and treatment from the comfort of their homes may have a positive impact on patient satisfaction and quality of life. Research indicates that more patients want to age in their own homes, rather than receive complex treatment inside of a medical facility. Remote patient monitoring makes that preference possible by allowing clinicians to track important patient metrics from afar. When a patient does need in-person medical attention, remote patient monitoring devices typically alert the clinician to the issue, making care seamless for patients.
All of this activity suggests that healthcare professionals will soon be facing a deluge of clinical data, some of which will need to be monitored. However, I have an inkling that hospitals will be slow to embrace home health monitoring and that large companies like UnitedHealth may be leaders in the field. I base my prediction on the following ideas:
- UnitedHealth is already functioning as a major service provider with its rapidly expanding MedExpress business unit (see: UnitedHealth plans to bet bigger in Texas).
- Health data monitoring requires sophisticated information technology. UnitedHealth has this capability with its Optum division that is already providing IT consultative services to hospitals (see: Optum Expands I.T. Services to Help Hospitals Modernize Their Technology Infrastructure, Meet Rapidly Changing Needs of Care Providers and Patients).
- Companies like UnitedHealth have access to large amounts of investment capital that will be necessary to provide home health data monitoring services.
- Home data monitoring will require sophisticated algorithms to scan incoming data and issue warnings when intervention is necessary, which also requires capital investment to develop.
- Home data monitoring will yield abundant patient referrals when rapid intervention is necessary which blends nicely with UnitedHealth's MedExpress division of urgent care centers.
I don't mean to suggest with these points that hospitals and health systems will be locked out of the home monitoring market. As I have noted previously, bedless hospitals are being configured as data-oriented centers and would be ideally suited for home monitoring (see: Some Additional Ideas About the Bedless Hospitals of the Future; The Design of Bedless Hospitals Continue to Evolve Based on Cost and Technology). Moreover, it will be the hospitals and health systems that have responsibility for most of the patients being monitored so they will be, by default, the organizations with the first opportunity to provide home support.