Remote patient monitoring (RPM) of blood pressure is associated with improved hypertension outcomes, researchers report, but also increased healthcare costs. “Our findings point to targeted patient eligibility and time-varying reimbursement as potential levers to explore for improving the value of RPM use for hypertension,” the authors conclude.
The matched observational study was designed to emulate a longitudinal, cluster-randomized trial. Among patients with hypertension on traditional Medicare, changes in outcomes from 2019 to 2021 were analyzied for patients with hypertension at high-RPM practices versus those at matched control practices with little RPM use.
Based on primary outcomes of hypertension medication use (medication fills, adherence, and unique medications received), outpatient visit use, testing and imaging use, hypertension-related acute care use, and total hypertension-related spending, the authors report: “192 high-RPM practices (with 19,978 patients with hypertension) were matched to 942 low-RPM control practices (with 95,029 patients with hypertension). Compared with patients with hypertension at matched low-RPM practices, patients with hypertension at high-RPM practices had a 3.3% (95% CI, 1.9% to 4.8%) relative increase in hypertension medication fills, a 1.6% (CI, 0.7% to 2.5%) increase in days’ supply, and a 1.3% (CI, 0.2% to 2.4%) increase in unique medications received. Patients at high-RPM practices also had fewer hypertension-related acute care encounters (−9.3% [CI, −20.6% to 2.1%]) and reduced testing use (−5.9% [CI, −11.9% to 0.0%]). However, these patients also saw increases in primary care physician outpatient visits (7.2% [CI, −0.1% to 14.6%]) and a $274 [CI, $165 to $384]) increase in total hypertension-related spending.”