A group of partners has launched a turnkey program to help pharmacies implement remote patient monitoring (RPM) and receive reimbursement.
The partnership is between telehealth infrastructure provider OpenLoop, RPM platform Tenovi, and RxHealing, which provides operational support to RPM pharmacies. The goal of this program is to enable pharmacies, especially rural independent pharmacies, to supervise and support chronically ill patients between scheduled visits.
There is no cost for pharmacies to set up the program, executives said. The program will initially bill Medicare Part B, with commercial expansion planned.
“This is very seamless and out-of-the-box,” OpenLoop co-founder and CEO Jon Lensing told Fierce Healthcare. “The work that[pharmacies]are being reimbursed for right now is what they’ve historically done anyway, so there’s no extra workload or burden on them at all.”
OpenLoop, a white-label operator that supports telemedicine companies, examines patients and bills insurance for the necessary clinical care, while Tenovi sources data from medical devices and sends it to relevant clinical teams, including pharmacists. Pharmacists participating in the program must work with an OpenLoop provider.
In 2019, CMS introduced RPM codes and ultimately expanded opportunities to other clinical staff, such as pharmacists, under the general supervision rule. These staff are authorized to set up equipment, educate patients, collect data, monitor equipment, and provide RPM treatment management services.
However, making RPM function as a pharmacy is not easy. Pharmacies must enter into cooperative practice agreements within the state, procure medical equipment, and find ongoing technical and clinical triage support. “After a few months, they say this is too much work and give up,” said Eric Lankford, CEO of RxHealing. The program solves all these components.
Lankford said the program launched in early April and received an enthusiastic reception. To date, 138 pharmacies have participated. Partners plan to track program impact and share data. “We think all pharmacies, from independent pharmacies to these corporate pharmacies, have clinical value for patients, so we want to move forward with providing that in some way,” Lankford said.
Rensing says pharmacies play an especially important role in rural areas, providing patient counseling and follow-up support. “Such patient education is often the first effort for many rural patients to participate in the broader ecosystem,” Rensing said.
Additionally, pharmacists have established trusting relationships with patients. “We see this as a way to leverage patient voice and patient influence in the community and gain patient trust and confidence,” said Brandon Haag, vice president of PBM, payer and pharmacy sales at Tenovi.
Lankford said there is no official CMS list of eligible diagnoses for RPM, but both chronic and acute conditions are eligible. RPM is based on medical necessity, as determined by the treating provider, rather than a specific diagnosis code. In fact, Lankford said, the most frequent conditions are those with measurable physiological signals, such as high blood pressure, diabetes, congestive heart failure, COPD, asthma, obesity, sleep apnea, and atrial fibrillation.
