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RPM vs. CCM: 5 Key Differences Explained

Jon-Michial Carter
Written by Jon-Michial Carter

Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) are distinct value-based care programs that complement each other to offer a more comprehensive and proactive approach to caring for your patients with chronic conditions. Effective management of chronic conditions relies on continuous access to care–RPM and CCM make this possible. 

RPM provides real-time access to health data transmitted from patients’ devices, while CCM extends care coordination, disease management, and education to patients with chronic conditions. With access to real-time patient health data, you can make more informed decisions, care for patients proactively, and personalize treatment plans to individual needs.

Within the next several years, healthcare providers expect RPM adoption rates to be on par with or surpass in-patient monitoring rates. But practices unfamiliar with starting CCM and RPM programs may be in for a rude awakening to the time investment and ongoing tasks required in developing and scaling these programs. 

We'll explore these challenges as we compare the differences and similarities between CCM and RPM and share how ChartSpan can assist you with ongoing patient enrollment and care management for a successful CCM or RPM program.

What is RPM?

Remote Patient Monitoring, sometimes called Remote Physiologic Monitoring, (RPM) uses wearable devices or apps, like heart rate or blood pressure monitors, to transmit patient vitals and other health data to healthcare providers for real-time monitoring and timely interventions. RPM devices notify the patient and provider of any changes in a patient’s condition, providing an opportunity for early intervention to prevent complications or hospitalizations. 

For example, one medical center uses RPM for diabetes management with data collected via tablets. Those tablets report glucose levels to the Center’s EHR so providers can follow up with patients whose levels spike. A recent survey of hospitals and clinics also revealed that 90% of respondents recognized the importance of access to 24-hour patient data with RPM. 

RPM empowers patients with health insights to better self-manage their conditions. While it particularly benefits patients with chronic conditions like diabetes, hypertension, or heart failure, RPM can also prove valuable for post-operative recovery or monitoring any illness requiring close attention.

What is CCM?

Chronic Care Management (CCM) focuses on coordination of care and support for patients with two or more chronic conditions. The primary goal of CCM is to improve the quality of care and minimize complications for these patients through proactive management of their chronic illnesses. 

CCM involves regular, remote communication with patients through phone calls or messaging to assist with prescription refills, adherence to personalized care plans, transportation, and appointment scheduling. 

Starting an RPM or CCM program can be challenging if you don’t have the time or staff to maintain ongoing care coordination and patient communication for CCM or patient enrollment for RPM. 

At ChartSpan, we understand the demands of value-based care programs and have the expertise and resources to help you streamline CCM and RPM workflows, so you can devote more time to providing face-to-face care.

5 key differences between RPM and CCM

Remote Patient Monitoring (RPM)Chronic Care Management (CCM)
1. IntentProvides 24/7 access to patient health data but does not involve the same level of patient engagement and assistance. Its value lies in the data it provides, which can be used to update or personalize chronic care plans.Supports patients in managing their chronic conditions through ongoing patient communication to ensure adherence to care plans provided by physicians, nurses, or clinicians.
2. EligibilityPrograms include chronic or acute conditions. Beneficial for a broader range of Medicare patients, as a diagnosis is not required.Programs require patients to have two or more chronic conditions for eligibility. Patients must have been seen by the billing provider within a year.
3. ImplementationCollects patient data in a health system's Electronic Health Record (EHR) using smart devices to transmit patient health data to providers in real time. The patient is responsible for setting up and using the device. Clinicians report on patient interactions, updates, and quality of care rather than specific vitals. CCM is driven by a team dedicated to educating and assisting patients.
4. Billing requirementsReimbursement can be claimed for 20 minutes of RPM services under codes 99457 and 99458, but time must be counted separately from time spent on CCM. Initial equipment set-up and patient education can be billed under code 99453, and daily health recordings can be billed under code 99454.Reimbursement can be claimed for 20 minutes of time dedicated to CCM services under CPT code 99490 or G0511 for FQHCs and RHCs, but time must be counted separately from time spent on RPM.

Learn more: How to Maximize CCM Reimbursements
5. Patient supportProvides real-time updates on health data and regular patient health monitoring, but not 24/7 access to nurse or provider support.Provides remote healthcare services with 24/7 access to a nurse line, where experienced nurses assist patients with health-related questions and needs.

An efficient workflow and dedicated staff are essential for successful Chronic Care Management and Remote Patient Monitoring programs. Learn how ChartSpan can help you streamline your CCM workflow and effectively enroll and engage patients in RPM

The relationship between RPM & CCM

CCM and RPM are independent services with complementary benefits that can enhance each other in improving quality of care, expanding access to care, and reducing healthcare costs. As remote health solutions, RPM and CCM meet the growing demand for convenient and personalized care as technology advances and becomes more affordable. 

RPM offers the advantage of timely and continuous data for interventions and more informed and personalized care plans for patients. CCM provides 24/7 support for patients with chronic conditions, addressing their health concerns and ensuring ongoing care management proactively. 

Patients with chronic conditions are great candidates for RPM because they often require regular monitoring. For this reason, the senior patient population, with a high occurrence of chronic illnesses, drives positive ROI for RPM programs

Benefits of RPM and CCM

1. Greater access to care

RPM and CCM improve access to healthcare services for individuals residing in remote or underserved areas. Patients can receive convenient care without having to travel long distances or find transportation.

2. Early intervention 

CCM and RPM identify potential health issues before they escalate. Monitoring vital signs and symptoms allows healthcare providers to detect changes or deterioration in patients’ conditions and intervene promptly. This proactive approach can prevent complications, reduce emergency room visits, and promote preventive care. 

3. Improved health outcomes 

By closely tracking patients' vital signs, symptoms, and overall health status, healthcare providers can make informed decisions and provide personalized care plans for patients with chronic diseases. Research also suggests that RPM and CCM programs can reduce hospital readmissions. 

4. Reduced exposure and in-person visits 

RPM and CCM services can equip providers with up-to-date information on a patient’s health status without requiring an in-office visit. 

The challenges of incorporating RPM and CCM at your practice 

RPM and CCM programs offer more extensive care for patients and reimbursement opportunities for your practice, but maximizing these programs is challenging. 

Costs and reimbursement 

Reimbursement is essential for successful RPM and CCM programs because of the quantity of work involved in offering these services. 

RPM requires capital investments in devices and software. RPM revenue may also be slow to materialize, and the program is more cost-effective for certain chronic conditions than for others. For instance, RPM for hypertension may be more cost-effective than RPM for heart disease or COPD, because hypertension produces fewer vital signs to monitor and therefore requires less expensive equipment. 

Additionally, providers cannot charge for RPM services unless patients enrolled in the program respond to and engage with clinicians, regardless of the level of effort invested, and RPM requires a patient copay. 

Earning reimbursement for CCM requires significant time and resources devoted to care coordination, disease management, and patient education. Meeting Medicare requirements can be challenging and time-consuming, especially your practice lacks efficient systems and processes. Some patients also struggle with the program’s copay or deductibles. 

Patient consent and enrollment 

Medicare requires that your practice receive patient consent from all patients eligible for RPM or CCM enrollment. This requires strategic patient marketing efforts and education on the program's value. 

Enrollment is often an unexpected challenge that creates a barrier to scaling RPM and CCM programs. Identifying and enrolling eligible patients is a tedious, ongoing effort as the eligible patient list changes and must be updated frequently. 

Patient enrollment in an RPM program can be low because of the high copay required. If patients don’t understand the value of RPM, they may assume that it’s an unnecessary expense and that they can manage their condition without remote monitoring. This lack of understanding creates a barrier to patient enrollment.

Read more: The challenges of RPM programs

The solution

Costs and enrollment challenges can hinder the success of your RPM and CCM programs. However, ChartSpan offers comprehensive solutions to address these issues. We provide a full-service CCM program to efficiently manage CCM responsibilities while ensuring your practice receives reimbursement for the ongoing care provided to CCM patients.

Additionally, our RPM Enrollment as a Service (EaaS) takes care of the ongoing and often time-consuming task of identifying and enrolling patients in your RPM program. By leveraging our services, you can streamline your RPM process and ensure a smooth and efficient enrollment experience for your patients.

Learn more: How to Enroll Patients in a CCM Program 

ChartSpan can help you maximize your CCM and RPM programs

ChartSpan's CCM program and RPM enrollment service alleviate administrative burdens and help you optimize reimbursements. Our services enable you to prioritize patient care within your office while effectively managing CCM and streamlining your RPM program. 

Here are just a few of the ways we can assist you:

  • RPM & CCM enrollment: We consistently identify and enroll eligible patients in your RPM and CCM programs.
  • RPM & CCM patient marketing: We apply proven marketing strategies to educate patients on the value of RPM and CCM to facilitate better patient engagement and obtain their consent.
  • CCM remote care: ChartSpan provides each CCM patient with 20 minutes of calls each month to address patients' health concerns, provide guidance, and ensure adherence to their personalized care plans.
  • CCM patient and family support: Our comprehensive services include a 24/7 nurse line that offers CCM patients immediate access to professional medical support. Additionally, we extend support to approved family members and caregivers, helping them navigate the challenges associated with caring for patients in CCM. 

RPM and CCM offer numerous benefits, including greater access to care, early intervention, improved health outcomes, and reduced exposure to in-person visits. However, implementing and maximizing these programs can present challenges in reimbursement, patient enrollment and education, and continuous remote care. 

ChartSpan can help your healthcare practice overcome these challenges and effectively manage your CCM program and RPM enrollment. With our support, you can streamline workflows, optimize reimbursements, and provide exceptional care to your patients. 

Partner with ChartSpan to maximize the potential of your RPM and CCM programs and provide more comprehensive and patient-centered care.

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