Editorial: Health monitoring saves lives, money

Reimburse doctors for technological remote health care.

Last update: August 11, 2007 - 4:15 PM

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THE COSTS OF CHRONIC DISEASE:

• Heart ailments: $431 billion

• Diabetes: $132 billion

Note: Annual figures include both direct health care expenses and indirect costs such as disability, work loss and premature mortality.

Source: Centers for Disease Control

New technologies that remotely collect and transmit health data are available; more are being developed every year. Devices can monitor vital signs and heart conditions of patients at home, for example, to alert doctors to problems and prevent or reduce costly office and hospital visits.

But while such life-enhancing, cost-efficient technology exists, too many patients can't use it. Currently, Medicare does not reimburse doctors for the time it takes to analyze and use the information. As a result, the system creates built-in incentives for costly office visits instead of less expensive remote monitoring.

It's a payment problem that should be fixed. To that end, Sen. Norm Coleman, R-Minn., introduced the Remote Monitoring Access Act. Under the proposal, a new Medicare reimbursement category would be created to reimburse physician time spent analyzing transmitted data. The benefit adjustment would cover distance management for congestive heart failure, cardiac arrhythmias, diabetes and sleep apnea -- ailments that affect millions of Americans and cost billions every year.

Closely monitoring a patient at home or at work reduces the need for face-to-face office visits. Distance monitoring minimizes unnecessary travel and missed work, and can improve quality of life for seniors. Those are big benefits for people living far from the nearest doctor or hospital. An estimated 40 percent of rural citizens live in medically underserved areas, with care an average of 30 miles or more away.

Such monitoring is not intended to completely replace office visits, but it can reduce the number to trips to the doctor and make necessary visits more productive. Closely watching a patient via technology might trigger a trip to the pharmacy rather than the hospital. And remote monitoring provides instant feedback so that interventions can happen quickly, which often saves lives.

Extending Medicare benefits to cover this part of remote monitoring won't be cheap. Senate staff estimates that the cost could run $330 million over five years. But if spending that much for monitoring can save an estimated 10 times as much in care management, office visits, hospitalizations and other related costs, then it is clearly worth the investment.

Not surprisingly, AdvaMed, a national coalition of medical technology companies (including Minnesota's Medtronic and St. Jude Medical) supports this expansion of reimbursable fees; these companies develop and manufacture much of the cutting-edge technology. But they also have an interest as employers and consumers. With over 18,000 Minnesota workers, they want the most cost-efficient care too. And if Medicare reimburses, more private insurers will as well.

Congress should approve this smart change to both improve care and make it more convenient and cost-effective.

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