Healthcare systems around the world focus on providing the best possible care, maximizing patient outcomes while also providing efficient services. As we look to the future, digital connected health technologies will play an increasing role in bringing healthcare into the home while still maintaining the highest levels of care and outcomes. Leveraging these technologies and providing reimbursement incentives will encourage adoption and collaboration between healthcare providers, patients and caregivers, and also offer significant opportunities to reduce costs.
One important case study for reimbursement models around connected health exists here in Europe, and relates to a disease that affects nearly one billion people worldwide, sleep apnea.
Continuous positive airway pressure (CPAP) devices are the most effective and widely used treatment for obstructive sleep apnea (OSA), a chronic condition strongly linked to an increased risk for other high-cost chronic conditions like high blood pressure,1 heart disease,2 and poorer glucose control in patients with type 2 diabetes.3 Consistent nightly CPAP use can help lower those risks and provide all the benefits of a full, uninterrupted night’s sleep. And patients who are both remotely and self-monitored via cloud-connected devices have been shown to be 87 percent compliant (compared to 50–60 percent on non-connected devices).
France has been a leader in recognizing the value of connected health solutions. Earlier this year, France validated the importance of remote monitoring technology in improving OSA therapy adherence through a new reimbursement model, wherein an incremental increase in reimbursement is paid for patients remotely monitored and adherent to their therapy.
Payers in Japan and the United States have taken similar steps to enable adoption of remote monitoring technologies:
- Japan recently adopted a reimbursement model for remote monitoring of OSA patients. Its model allows payment for remote data review twice per quarter.
- The United States’ public payer, Medicare, amended the use of an existing remote monitoring reimbursement code for collection and interpretation of physiologic data for 2018, signaling its willingness to consider new reimbursement codes for 2019 developed by the American Medical Association.
I commend health agencies in France, Japan and the United States for taking steps to expand coverage of remote patient monitoring and other connected health services. While some countries have unveiled their intent to reimburse for these services, continued engagement is needed and feedback from stakeholders with direct experience can improve proposed reimbursement models.
I look forward to other countries and healthcare systems exploring new payment models to incorporate and drive further adoption of connected health technologies. Our opportunity to provide effective care to patients while improving business efficiencies and lowering costs are welcome in all corners of the world.
Lucile Blaise is ResMed’s vice president for Western Europe, and vice chair of the MedTech Europe’s Digital Health Sector Working Group.
- Lavie P, Herer P and Hoffstein V. Obstructive sleep apnoea syndrome as a risk factor for hypertension: Population study. Br Med J 2000;320:479–82.
- Shahar E et al. Sleep-disordered breathing and cardiovascular disease: Cross-sectional results of the Sleep Heart Health study. Am J Respir Crit Care Med 2001;163(1):19–25.
- Aronsohn RS et al. Impact of untreated obstructive sleep apnea on glucose control in type 2 diabetes. Am J Respir Crit Care Med 2010;181(5):507–13.