A number of pilot studies suggest that remote monitoring can improve patient health and reduce costs. A study published in the Lancet earlier this year found that heart-failure patients with a wireless implant designed to measure pressure had fewer hospital visits. In a second Lancet study, published by researchers in the United Kingdom, patients with hypertension who measured blood pressure at home, in combination with remote monitoring from physicians, were better able to control their hypertension. That’s likely to reduce a patient’s long-term health costs.
With the current system, “there are no incentives for preventive care; no one gets paid for keeping you from needing these services,” says Hansen. “That’s especially true for behavior-related issues, such as obesity, diabetes, congestive heart failure.”
Hansen and others hope that the Affordable Care Act will help to alleviate this problem. Part of the legislation funded the Center for Medicare and Medicaid Innovation, which is testing new payment models. One option is that providers are paid a monthly amount to take care of patients and are able to share in the financial savings that may result. (This approach, often called “bundled payments,” is similar to that of Kaiser Permanente’s.)
Of course, new technologies don’t always save costs. But with a bundled payment system, health-care providers will have more incentive to find the ones that do.
Leslie Saxon, a cardiologist and director of the Center for Body Computing at the University of Southern California, says that the reimbursement structure isn’t the only problem. In cardiology, recent additions to the Medicare billing codes do pay physicians to track heart patients remotely. But she says only about half of them do.
“I think the issue is largely cultural,” she says. “We’re not used to practicing medicine this way. That is why I think patients will need to be the drivers of this change also.”