The Institute will be identifying and facilitating approaches to stimulate the production of cost-effective wireless health solutions, with value propositions for multiple stakeholders – including third-party payers, providers, physicians, end-users and caregivers.
Historically, medical device manufacturers have relied on the government (Centers for Medicare & Medicaid Services) and private insurers for reimbursement as part of a procedure, diagnostic-related group, home-care fee, or stand-alone device. It often takes years to navigate the reimbursement coverage, coding and payment process. The Institute will endeavor to change this antiquated and arcane system of reimbursement to reflect the realities and opportunities of twenty first century medicine.
For example, home monitoring equipment allows patients to "capture" vital sign data, link to a communications network, and transfer the information to a care team. Cost savings are evident through earlier diagnosis and intervention. However, reimbursement is limited by many health plans to 30-60 days post-hospitalization for acutely ill patients.
The Institute will be working individually and in concert with other organizations to ensure that wireless health solutions are cost effective and eligible for reimbursement. In addition, the Institute will work to ensure that 'alternative' payment options that bypass third-party reimbursement and are not covered by insurance are cost-effective and within reach of those most in need.
Savings With Remote Monitoring Per Year
Robert Litan, Vital Signs via Broadband, October 2008.