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The evidence supporting remote patient monitoring (RPM) during the perinatal period continues to stack up. RPM for blood pressure monitoring postpartum has been associated with fewer hospital readmissions and significant cost savings. RPM for gestational diabetes has demonstrated improved glycemic control and reduced healthcare utilization without compromising quality of care. RPM for behavioral health has improved completion of EPDS surveys.
Other well-documented clinical and system-level benefits of RPM include:
- Reduced ED visits, particularly for postpartum hypertension
- Improved adherence to monitoring protocols, enhancing early detection and intervention
- Greater patient engagement and satisfaction, fostering trust and adherence to care plans
- Mitigation of racial disparities often observed with traditional in-office surveillance models
- Cost savings resulting from decreased acute care utilization and improved care efficiency
Yet, despite mounting evidence and progressive moves by commercial payers, State Medicaid reimbursement policies continue to lag behind. This inequity leaves high-risk Medicaid beneficiaries without access to high-quality, connected maternity care—those who would benefit from RPM the most.
Even when State Medicaid Agencies (SMA) include RPM in maternal health policies, reimbursement rates are often insufficient. They fail to meaningfully incentivize provider adoption or to cover essential components of RPM programs such as device costs, data transmission, and clinician time spent reviewing patient-generated data. Coverage frequently excludes the postpartum period—neglecting a critical window when maternal health complications are most likely to emerge.
SMA reimbursement rates for RPM often fall below those established by the CMS National Physician Fee Schedule for equivalent services. This creates a two-tiered system where Medicaid beneficiaries face barriers to RPM solutions that are readily available to commercially-insured and Medicare patients. The consequences are tragic: In Tennessee, maternal health-related deaths among individuals covered by TennCare occurred at three times the rate of those with private insurance.
To address these disparities and unlock the potential of RPM for all pregnant and postpartum individuals, Medicaid coverage policies must be updated to:
- Expand RPM coverage throughout the entire perinatal period, from pregnancy through 12 months postpartum
- Reimburse RPM services at rates consistent with CMS’s National Physician Fee Schedule, ensuring fair compensation and program sustainability
- Incorporate a comprehensive range of RPM CPT codes, accommodating various use cases, from blood pressure monitoring to gestational diabetes to behavioral health.
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