In this guest post by Dave Vreeland, Managing Director of Jumpstart Capital, our sister company and growth fund counterpart, Vreeland shares his insight into the recent updates to the CMS billing for Remote Patient Monitoring (RPM) services.
Over the past 100 years, disease has progressed from infectious to chronic. Chronic diseases e.g. heart disease, diabetes, obesity, are often preventable, and frequently manageable with lifestyle adjustments. With chronic diseases, the need to monitor the condition is long-term, thus making remote patient monitoring and telehealth a key aspect to convenient, health management. RPM and telehealth can shift the focus from intervention and thus the breaking news on the new CPT codes has a high potential for impact for our portfolio companies and the whole healthcare industry.
"Remote Patient Monitoring (RPM)" and "Telehealth" have gotten a good deal of press lately, in no small way because CMS rolled three new CPT codes (99453, 99454, and 99457) into its 2019 physician fee schedule late last year, all of which enable for the first time, physicians to be reimbursed for RPM services by the Medicare program. In our view this is huge - having lived through the intended and unintended consequences of the HITECH Act of 2009, I believe that we're going to see a real sea change in the use of RPM by thousands of primary care physician and certain specialists, and the results will be interesting to watch.
Clearly the intention here is to give a broad based incentive with limited constraints, for these types of technologies to get out in the marketplace in a broad fashion. Why? So CMS can learn whether such monitoring has an effect on readmissions, lengths of stay, and inpatient days in general. The idea is a good one in my view, and the way that CMS has gone about this is smart because they've allowed for a broad range of monitoring types to be supported.
One of our portfolio companies, Pillsy, has responded to this new opportunity in a substantial way. CEO Jeff LeBrun has rebranded the company "Optimize.Health" and is now going to market as a RPM platform offering standard monitoring tools such as connected scales and blood pressure cuffs, as well as its own proprietary medication compliance solution - the Pillsy smart pill cap. In like fashion other companies will bring their own innovations to the table and I believe that this marketplace approach will have a huge impact on the kinds of things CMS is hoping to affect.
We at Jumpstart Capital are excited to have three companies in our portfolio (and Jumpstart Foundry also has cliexa in theirs) that will benefit from this new set of CPT codes and we're looking forward to seeing how things play out over the course of 2019.
Dave Vreeland leads Jumpstart Capital after nearly fifteen years in various leadership positions at Cumberland Consulting Group, a healthcare IT consulting firm he co-founded and helped build into a 400+ consultants/$100M/year business working with a private equity partner and assisting with three acquisitions and post-merger integration.