Remote monitoring of diabetics: Applications and reimbursement
Are payers paying?
At Humana, based in Louisville, Kentucky, remote monitoring for people with chronic health conditions, such as diabetes, is done through its Humana At Home care management services. Members do not incur an additional cost for using the service.
Philis-Tsimikas says CGM monitors are usually covered by payers for people with type 1 diabetes, although Medicare does not cover them at this time. Some payers will cover meters that use remote monitoring technology.
While glucose monitoring can benefit diabetic patients, they can also reap advantages from other types of remote monitoring, such as devices that measure circulation in the feet to detect risk for foot ulcers or measure weight or blood pressure (all of which are currently available). “Most diabetic patients have either several comorbid conditions or end-organ damage,” Painter says. For example, monitoring for foot ulcers or for falls could help prevent more serious health conditions.
Philis-Tsimikas would like to see a more integrated approach to managing patients with diabetes by care managers within primary care and diabetes specialty departments. “If data is streaming in and stratified to have the situations needing immediate attention rise to the top, then care managers can use guiding algorithms and order sets to more quickly address and correct concerns,” she says. “Physicians would be available to back up the care managers when more complex questions present themselves.”
Consequently, more immediate care could be provided to individuals with highest needs. Those with lower urgency would still get attention, but might be provided education and support by other team members.
Karen Appold is a medical writer in Lehigh Valley, Pennsylvania.