Practices that struggle with remote care programs often share a common thread: assumptions brought in at the start that no one examined closely enough to challenge. According to the report, these assumptions can hold back the success of remote care programs.
One such assumption is that remote monitoring is only for the highest-risk patients. However, Medicare’s remote patient monitoring benefit isn’t gated on acuity, and any Medicare beneficiary with a chronic condition can qualify.
Remote Monitoring for Chronic Conditions
The patients who benefit most from remote monitoring aren’t necessarily the sickest, but those whose conditions are manageable with consistent data over time. Hypertension is a clear example, where a patient whose blood pressure has been creeping up for six weeks can be caught and managed proactively.
The 2026 code set reinforces this, with two new RPM codes that lower the monitoring threshold, making RPM viable for patients who don’t require daily monitoring.
A retrospective analysis of 655 hypertension patients enrolled in an RPM program found that patients who started with stage 2 hypertension saw the largest blood pressure improvements over nine months, but the program produced meaningful results across the full patient spectrum.
Common Assumptions About Remote Care Programs
Another assumption is that starting a remote care program requires hiring new staff. While it’s true that a well-run program generates enough patient volume to create real work, the more useful framing is that a well-run program funds the staff it requires, with RPM and chronic care management generating meaningful per-patient monthly reimbursement.
Practices can also consider outsourced care management services as a practical path to getting started without a hire, or to keep overhead lean while building their program.
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Some practices assume that RPM and other care programs don’t work well together, but in reality, they reinforce each other, with RPM generating a stream of physiologic data between visits, and CCM providing the care management infrastructure to act on it.
Operational Considerations
Operationally, RPM data gives care managers something concrete to work from during care management time, making interactions more targeted and easier to document. The billing follows from the clinical reality, with patients who qualify for both programs able to be billed for each in the same month.
According to CMS, the key to successful remote care programs is to challenge assumptions and understand what the benefit covers, what the technology requires, and what the team can realistically absorb.
By doing so, practices can create viable remote care programs that improve patient outcomes and generate revenue, rather than letting assumptions hold them back.
They can improve patient outcomes.
Practices can create viable billing codes for their remote care programs.
Understanding the benefit is essential.
