Remote Physiologic Monitoring Use Among Medicaid Enrollees Skyrocketed From 2019 to 2021

Between 2019 and 2021, the use of remote physiologic monitoring (RPM) via wearable devices and mobile applications soared by more than 1,300% among Medicaid enrollees, which was driven by a small number of providers, according to a recent Health Affairs study.

Based on Transformed Medicaid Statistical Information System Analytic Files data from Jan. 1, 2019, to Dec. 31, 2021, the study found that the number of RPM recipients per 100,000 Medicaid enrollees increased from 2.1 recipients in 2019 to 29.6 recipients in 2021 and started to accelerate with the March 2020 onset of the COVID-19 public health emergency. Among over 5,600 distinct providers who billed RPM claims for Medicaid enrollees in 2021, more than half of the claims were from 5% of providers.

The use of RPM varied significantly across states, ranging from 0 recipients per 100,000 enrollees in Vermont to 217.7 recipients per 100,000 enrollees in New Jersey. As of March 2023, 34 states had documented policies on Medicaid reimbursement for RPM services. The rate of RPM use in 2021 was more than 30% higher in states with documented policies than in states without such policies.

Among the providers who submitted Medicaid claims for RPM in 2021, internal medicine, general practice and family practice doctors billed for remote monitoring claims the most. In 2021, almost 67,000 Medicaid beneficiaries had claims for RPM devices. Rates of use were highest among enrollees diagnosed with diabetes or hypertension, older enrollees and people enrolled in limited benefit managed care plans.

The researchers recommended state Medicaid agencies to consider “using multiple levers to increase appropriate remote physiologic monitoring use, such as ensuring adequate coverage and reimbursement for remote physiologic monitoring, disseminating updated coverage policies to providers likely to bill these services, developing technical assistance resources for providers, and working with commercial payers to encourage benefit alignment” as RPM services may play an important role in improving health care quality.

This infographic was reprinted from AIS Health’s biweekly publication Radar on Drug Benefits.

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