COVID accelerates intersection of DME, remote care

YARMOUTH, Maine - The COVID-19 pandemic has unlocked telehealth, creating new opportunities for home-based care and DME, particularly in rural America, says Dr. Jacob Warren.

Under the public health emergency, CMS has expanded the use of telehealth and, while it's too soon to know whether these changes will be permanent, it's unlikely that the agency will be able to put that genie back in the bottle, said Warren, a behavioral epidemiologist in the Mercer University School of Medicine during “Rural health care and COVID-19: Where technology and home care must meet” at the virtual HME News Business Summit, Sept. 15-17.

“Reading the tea leaves, the consumer now has realized the convenience and the power of home-based care and I'm optimistic that there will be substantial pressure to maintain this access,” he said. “I think there will also be pressure from providers because they can see more patients in a more efficient way.”

DME and remote monitoring intersect

In rural areas, issues like lack of transportation, hospital closures, unemployment and lack of insurance create barriers to access and can contribute to higher rates of chronic disease, even in a non-pandemic environment, said Warren. While remote patient monitoring has long been a way to increase access, the pandemic has accelerated its use, positioning providers and the increasingly sophisticated equipment and services they provide to play a larger role in the continuum of care, he said.

“The line between DME and RPM equipment is getting blurred,” he said. “As we talk about things like smart glucometers, mobility tracking chairs, and CPAPs that have smart build-ins—COVID has pushed all of this forward by leaps and bounds.”

Operating outside limitations

The ongoing shift toward outcomes-based reimbursement is also going to accelerate the use of RPM, even when it's not covered under insurance, said Warren. That's especially true as Federally Qualified Health Centers step in to fill the gap created by hospital closures in rural areas, a trend that has only increased because of the pandemic.

“FQHCs are very innovative in the way they track their outcomes, so if they start to see that an individual who's given a smart glucometer gets better outcomes, they might be willing to help defray the cost of that,” he said. “There's a lot of intersection here.”