Remote physiologic monitoring (RPM), digital tools that collect and analyze patients’ health data between visits, is showing strong potential to transform primary care. A new study from the Columbia University Mailman School of Public Health, published in Health Affairs, reveals that RPM not only improves chronic disease management but can also enhance practice revenue and expand care capacity.
The study is the first to measure the impact of RPM from the perspective of healthcare practices, examining how its use affects care delivery, staffing, and resource allocation. By analyzing national Medicare data from 2019 to 2021, researchers reviewed 754 primary care practices that implemented RPM. Within two years, these practices experienced a 20% increase in Medicare revenue compared to those that did not adopt the technology. While most of this growth came from RPM billing, about a quarter was linked to increased care management and outpatient consultations.
RPM adoption
Importantly, RPM adoption did not limit access for other patients. “There were concerns that dedicating more time and resources to RPM might reduce availability for non-participating patients,” said Dr. Mitchell Tang, assistant professor of Health Policy and Management at Columbia. “Instead, we found that practices served more patients overall, particularly those with complex health needs, including individuals from underrepresented and lower-income groups.”
According to Dr. Ariel D. Stern, professor of Digital Health, Economics and Policy at the Hasso Plattner Institute, the findings highlight the potential of digital health to strengthen frontline care. “Our research offers cautious optimism that technologies like RPM can make primary care more proactive, equitable, and patient-centered.”
Higher Medicare spending
However, the authors also warn that uncontrolled expansion of RPM could lead to higher Medicare spending. They advocate for evidence-based reimbursement policies, including limits on monitoring duration and patient eligibility, to ensure sustainability and maintain high-value care.
The research team, including experts from Massachusetts General Hospital and Brown University, concludes that thoughtful integration of RPM can help relieve primary care pressures, improve outcomes for patients with chronic conditions, and support a shift toward more continuous and preventive healthcare delivery.
As health systems worldwide look to manage growing demand and workforce shortages, the study underscores that digital monitoring solutions, when properly implemented, can simultaneously enhance care quality and operational efficiency, marking an important step toward a more connected, data-driven model of primary care.
RPM success factors
Back in 2021, at the height of the Covid-19 pandemic a debate emerged around remote patient monitoring, with critics warning it could worsen clinician burnout through technostress, time pressure, and workflow disruptions. Others, including the New England Journal of Medicine, point to issues with reimbursement in fee-for-service systems that reward volume over value. Experts now argue for a comprehensive, evidence-based approach to virtual chronic care that combines effective devices, user-friendly design, and meaningful data presentation to improve outcomes without adding clinician burden.
Successful examples include virtual hospitals and remote command centers staffed by nurses who monitor patients at scale, reducing workload for primary care physicians. However, large outcome studies demonstrating reduced hospitalizations or better health outcomes remain limited. Programs such as digital diabetes prevention initiatives show promise, reporting results equal or superior to traditional outpatient care. Current fee-for-service reimbursement is ill-suited for chronic disease management, which requires continuous, preventive engagement. Transitioning to value-based care models could incentivize outcome-driven care while mitigating burnout.
For RPM to succeed, health systems must ensure:
- Actionable data visualization for clinicians, such as trend graphs in electronic medical records.
- Payment models that reward quality and stability in chronic disease management.
- Streamlined workflows that simplify care delivery.
- Patient-centered design, including easy setup, individualized support, and inclusive accessibility.
Ultimately, integrating RPM into value-based frameworks offers the potential to make chronic care more efficient, proactive, and sustainable, benefiting both clinicians and patients alike.
