Navigating Common Barriers to Remote Patient Monitoring Enrollment

Medicare covers more than 70 million beneficiaries, yet fewer than 1 million received Remote Patient Monitoring (RPM) in 2024. A 2026 study in JAMA Network Open likewise found low adoption among Medicare patients with hypertension, a population that may benefit from remote monitoring. While RPM use is growing across the Medicare population, these figures suggest that the program has the opportunity to reach more patients who could benefit from remote monitoring.

Expanding RPM requires more than identifying good candidates. Concerns about out-of-pocket costs, difficulties with device setup, and the time required to consent and enroll can all prevent eligible patients from getting started. Addressing these barriers and connecting RPM with broader care management efforts can help practices build a more consistent enrollment process.

Common barriers to RPM enrollment

Most Remote Patient Monitoring enrollment barriers appear after a patient has already been identified as an appropriate candidate. Patients may hesitate to enroll if they're unsure about costs, have trouble getting their devices set up, or are unable to get the answers they need from practice staff.

Patient cost-sharing

Potential out-of-pocket costs are one of the most common reasons patients hesitate to enroll, particularly when they are unclear about what they will owe. When patients hear that they may owe a copay without understanding how much they could pay, uncertainty about the cost can become a barrier to enrollment.

A patient’s cost-sharing depends on factors such as insurance coverage and deductible status, so the amount they owe can vary from patient to patient. Explaining these factors upfront with a clear, consistent script helps walk the patient through each cost scenario they may encounter.

For example, ChartSpan provides a monthly cost estimate, lets the patient know deductibles will apply, and gives the patient an estimate of how much their payment will be after they meet their deductible. ChartSpan enrollment specialists also share that costs may be higher before the deductible is met and that secondary insurance may cover some or all of their cost-sharing.

Clear cost disclosures help patients make informed decisions and are also an important part of compliant RPM enrollment. Medicare requires documented patient consent for RPM, and practices should explain potential costs before patients agree to participate. Clearly setting these expectations can also help patients understand their financial responsibilities from the outset.

Device and vendor friction

Even after a patient agrees to participate, several points of friction can cause them to disengage before they take a first reading:

Delays in device shipping or confusing setup steps
Concerns about technology, such as needing a smartphone or pairing a device via Bluetooth
Uncertainty about how monitoring works, how often readings are needed, or who reviews the data
A hand-off to an unfamiliar vendor the patient did not expect to hear from
A lengthy or fragmented enrollment process that requires multiple calls or forms

For patients managing chronic conditions, each additional step or unanswered question can make participation feel more difficult. Devices that transmit readings to the care team automatically, clear setup instructions, and a consistent point of contact can make onboarding easier and help patients confidently take their readings.

Workflow and staff capacity

On the practice side, enrollment involves a sequence of tasks that each take time. Your staff must identify eligible patients, explain RPM, answer questions, verify coverage so the cost disclosure is accurate, obtain and document consent, coordinate device delivery, and follow up with patients who have not yet started transmitting data.

These responsibilities compete with clinical work. Nurses, medical assistants, and front-desk staff may need to fit enrollment conversations around patient visits and other administrative duties, making it difficult to maintain a consistent process.

Enrollment also requires skills and resources beyond clinical decision-making. Clinicians can determine whether RPM is appropriate for a patient, but completing enrollment may require coverage verification, clear explanations of costs and expectations, and thorough documentation. When these tasks fall to staff who are already stretched thin, enrollment can become inconsistent.

What successful enrollment requires

Addressing these barriers requires a well-designed enrollment process that practices can apply consistently. An enrollment workflow should include clear patient communication, hands-on support with devices and logistics, and a staffing model that does not depend on clinical staff finding spare time.

The enrollment experience can influence whether patients follow through with participation. A patient who receives a clear explanation of costs, straightforward device setup, and follow-up from a consistent point of contact has a clearer path to beginning monitoring than one who hears a brief mention during a visit and receives a device weeks later with little additional support.

Barrier	What patients need	What your practice needs
Patient cost-sharing	A clear, specific explanation of potential costs before they decide	Coverage verification and a consistent cost-sharing script
Device and vendor friction	Simple devices, setup support, and a consistent point of contact	Reliable device logistics and a defined onboarding and follow-up process
Workflow and staff capacity	Timely answers and follow-up on device readings	Dedicated capacity that does not pull clinical staff from patient care

Enrollment is only the first stage of a functioning RPM program. Once patients are enrolled, your team still needs clinical review and escalation workflows to turn incoming data into timely follow-up.

Bringing ChartSpan's enrollment expertise to a full-service RPM program

RPM enrollment requires many of the same patient communication and operational processes that support enrollment in other Medicare care management programs. ChartSpan has spent years developing those processes across its care management programs and now applies that experience to its full-service RPM offering, combining enrollment support with the technology and clinical services needed to manage RPM.

ChartSpan's experience with patient enrollment

ChartSpan has spent years refining enrollment processes for Medicare care management programs. Across CCM and APCM, ChartSpan currently achieves average enrollment rates of approximately 45% among primary care patients and 35% among specialty clinic patients. These figures reflect enrollment in care management programs rather than RPM, as RPM-specific enrollment data is still forthcoming, but they offer a glimpse of the benefits dedicated enrollment staff can achieve.

Dedicated enrollment specialists manage the enrollment conversation, educate patients about the program through multiple channels, and explain cost-sharing before consent is requested. Providers review patient lists and confirm which patients are appropriate for enrollment, and care managers or enrollment specialists document consent in the patient record. ChartSpan also records every enrollment call and retains those recordings for ten years, providing documentation that can support audit readiness.

Full-service RPM support

ChartSpan's new full-service RPM offering extends that enrollment experience into Remote Patient Monitoring. The model combines RPM technology with clinical care management support to help your practice address the practical demands of enrolling and supporting RPM patients, including:

Patient onboarding, education, and ongoing engagement
Device management and logistics
Monitoring of incoming readings and escalation to providers when needed
Documentation that supports compliant billing

ChartSpan's acquisition of Validic added RPM software, a health data platform, and device logistics and support to ChartSpan's clinical services. With both the technology and clinical team under one organization, ChartSpan can support the patient journey from enrollment through device setup and ongoing monitoring.

This full-service support helps practices expand RPM participation without taking on every part of enrollment and program management internally. Providers retain clinical oversight, including determining which patients are appropriate for RPM, while ChartSpan's team handles patient outreach, onboarding, and review of device readings. If a reading requires support from a provider, such as an in-office visit or medication adjustment, the care manager notifies the practice. For practices that already have the staff and workflows to manage RPM internally, ChartSpan also offers RPM software separately.

Why RPM works alongside CCM and APCM

Integrating RPM with existing care management programs such as Chronic Care Management (CCM) and Advanced Primary Care Management (APCM) can create additional opportunities to introduce RPM when it is relevant to a patient’s ongoing care. Patients already engaged through care management have established relationships with their care team and are used to regular outreach between office visits. When RPM comes up, patients can hear about it from the care team already supporting them, rather than encountering it as a separate program or service.

Those existing touchpoints also create opportunities to identify patients who may benefit from monitoring. A care manager who speaks with a patient each month about blood pressure or weight changes is well positioned to recognize when connected-device data could inform that patient's care, and to introduce RPM in the context of their broader care plan. Not every CCM or APCM patient is a suitable RPM candidate, and clinical judgment still determines who should be monitored. Integrated programs create more opportunities to identify and engage the right patients.

If a practice launches care management and RPM at the same time, their patients can benefit from RPM data that is integrated into monthly care management support, so their care manager can view the data when assisting them with care goals, medication refills, or local resources.

Integrating RPM into those existing workflows also means enrollment does not have to operate as a separate initiative with its own outreach, staffing, and patient communication. Practices can incorporate it into the care management workflows and patient engagement strategies already in place or rely on their care management partner to do so.

Learn more: Layering Remote Patient Monitoring onto Your Chronic Care Management Program: A Guide for CCM Practices

Partner with ChartSpan to strengthen RPM enrollment

The value of an RPM program depends on getting appropriate patients enrolled and actively participating in monitoring. For practices with programs already in place, a practical next step is to examine where eligible patients drop off, whether during the cost conversation, at device setup, or when they no longer see meaningful follow-up based on the data they are collecting, and build an enrollment and engagement process that addresses each point.

ChartSpan's full-service RPM brings the enrollment approach used across its care management programs to Remote Patient Monitoring. It also connects RPM with CCM and APCM, allowing practices to incorporate RPM into broader care management workflows.

If you're looking for ways to strengthen RPM enrollment without adding to your team’s workload, talk with a ChartSpan expert about how full-service RPM can support patient onboarding, device management, and ongoing monitoring.

Talk with a ChartSpan Representative Today!

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Navigating Common Barriers to Remote Patient Monitoring Enrollment