Chronic conditions affect a staggering number of Americans every year. More than 60 percent of adults in the U.S. have a chronic condition, with 40 percent diagnosed with two or more. In fact, seven out 10 deaths are attributed to chronic and mental health conditions.
Treatment of chronic conditions also bears a considerable economic burden on the healthcare system. Overall, an estimated $3.8 trillion dollars is spent on healthcare every year in the U.S., with the vast majority (90 percent) devoted to caring for chronic health and mental conditions.
While exact figures can vary, treatment of chronic conditions can also put a significant financial strain on insurance payers, as well patients and their families.
Long-term treatment for chronic conditions involves significant cost – both financial and physical. Fortunately, however, studies have demonstrated that Remote Patient Monitoring (RPM) programs can help manage chronic conditions, with regular, ongoing measurement of physiologic data, feedback, and communication.
Here is a list of the most costly chronic conditions that can be managed with RPM, ranked by direct medical cost1 on a national level. That is, costs incurred for medical products and services used to prevent, detect, or treat a disease. However, this does not include ancillary costs such as missed days of work.
According to American Diabetes Association (ADA), the national cost associated with prediabetes is $43.4 billion. For U.S. adults with prediabetes, the annual economic burden is $500 per person. Approximately 1 in 3 Americans has prediabetes.
Patients with prediabetes are particularly ideal candidates for RPM. Because this form of monitoring facilitates not only prediabetes management, but diabetes prevention, it provides the patient with a tangible motivation for adhering to their reading schedule.
The most common means of managing prediabetes through RPM is through the use of a connected weight scale as part of a digital Diabetes Prevention Program (DPP). These scales give providers more real-time updates into patient weight management, allowing them to track patient progress, deliver helpful tips or recommendations to facilitate greater progress in-between visits, and offer a more complete trendline to be used during a visit.
When paired alongside other commonly prescribed diabetes prevention measures, RPM has proven to be effective at helping patients to decrease their weight, increase their physical activity, and reduce patient medical costs.
According to a projection shared by the Centers for Disease Control and Prevention (CDC), overall costs attributable to having Chronic Obstructive Pulmonary Disease (COPD) added up to $49.0 billion in 2020. Chronic lower respiratory disease, in particular, is a leading cause of death in the U.S. It is reported that roughly 15.7 million Americans (6.4 percent) have been diagnosed with COPD.
While there is no treatment to reverse or cure COPD, RPM can help patients with symptomatic management.
Pulse oximeter devices allow for measuring of oxygen saturation, a critical vital sign indicating decompensation of COPD. Providing pulse oximetry based RPM solutions, transforms the paradigm of COPD care empowering patients to better understand their disease state and providers to engage with patients when they would benefit from extra support.
Studies demonstrate that COPD patients find RPM easy to use and are willing to use their connected pulse oximeters throughout the pulmonary rehabilitation process. Additionally, an oximetry-supported self-management for chronic obstructive pulmonary disease pilot study demonstrated that patients felt more awareness of their condition and confidence in making self-management decisions.
In pulmonary rehabilitation programs which promote education, peer support, and physical activity, pulse oximeters provide the ideal objective complement to assess pulmonary status.
There is a lack of consensus on diagnostic criteria determining overall cost of treatment for heart failure. However, the Journal of the American Heart Association estimates that total direct medical costs of heart failure were estimated at $21 billion in 2012, and are projected to increase to $53 billion by 2030. About 6.2 million adults in the U.S. have heart failure.
The most common etiology of an exacerbation of heart failure is an overload in the lungs and lower extremities leading to shortness of breath. A mainstay of heart failure treatment at home is to encourage patients to weigh themselves daily, with a sudden increase in weight used as a proxy indicator for an increase in fluid buildup. However, many patients may find it difficult to adhere to daily weighings and medications.
RPM empowers patients to manage their heart failure in the comfort of their home. Instead of placing the burden on patients and their caregivers to take daily weights, a connected RPM solution allows providers to proactively reach out to heart failure patients and adjust medications as needed to decrease preventable heart failure admissions.
Systemic review and meta-analysis demonstrates that heart failure patients participating in RPM programs benefit from a reduction in mortality, and higher satisfaction of care. Additionally, patients demonstrated a reduction in rehospitalization rates.
Overall Medicare costs for people with Chronic Kidney Disease (CKD) were over $81.8 billion in 2018, or $23,700 per person. Fifteen percent of adults in the U.S. have chronic kidney disease (CKD). As many as 90 percent of adults with CKD do not even know they have it.
The Kidney Health Initiative convened a multidisciplinary workgroup to examine the state of telehealth and explored the way telemedicine could “increase independence, improve quality of life, and improve outcomes while aligning with patient and family preferences.”
Using RPM, patients can monitor their blood pressure from home. In addition, patients can be equipped with glucometers to mitigate progression of their concomitant diabetes. Additionally, connected weight scales can support patients in achieving weight goals that will lessen the strain on their kidneys. Together, providers can integrate these various RPM capabilities to personalize treatment for each patient to prevent progression of their chronic conditions.
A study demonstrated that providing weekly vital sign assessment, as well as subjective wellness assessment, combined with wrap-around aging services, led to a decrease in hospital visits and readmissions among senior populations.
A study published by the NIH estimates that the direct medical costs of treating hypertension nationally is $91.4 billion. Nearly half of all adults in the U.S. have hypertension. Hypertension is a risk factor for heart disease and stroke, which are leading causes of death in the U.S.
With remote blood pressure monitoring, patients and providers can view trends and acute blood pressure readings in real time. Healthcare providers can then triage contacting patients who may be approaching hypertensive crises. In addition, providers can gain a sense of when to engage with patients who may benefit from long-term management of blood pressure.
Studies demonstrate that improving control of blood pressure drastically improves cardiovascular risk, 20-25% for heart attack, 35-40% for stroke, and 50% for heart failure. RPM improves blood pressure control, decreases blood pressure medications needed, and decreases inertia in medication management.
The CDC estimates obesity-related medical care at approximately $147 billion. Obesity-related conditions can include heart disease, stroke, type 2 diabetes and certain types of cancer. More than 40 percent of adults in the U.S. are considered obese.
Losing and maintaining weight loss is obviously no easy task. Once again, connected weight scales equip patients with support for adherence in checking their weights and visualizes trends with weight overtime. RPM programs remove the friction of patients compliance with daily weigh-ins, recording these numbers, and bringing it to their provider to discuss their progress with weight loss. Furthermore, integration of the weight trend data into a database enables providers to engage and reach out to patients who are deviating off their weight goals.
Studies demonstrate that patients who use connected weight scales daily achieve greater weight loss. In addition, telehealth methods such as mobile phone based coaching and videoconferencing can be a useful tool for supporting significant weight loss among obese patients.
The American Diabetes Association (ADA) estimates that the nationwide annual cost of direct medical treatment of diabetes is $327 billion. Individuals diagnosed with diabetes incur average medical expenditures of $16,752 per year, of which about $9,601 is attributed to diabetes. Diabetes affects roughly 1 in 10 Americans.
RPM can help diabetes patients avoid acute life threatening incidents and provide overall long term management of their disease.
As patients check their blood glucose levels, clinical staff can be alerted to abnormal high or low readings and check in with the patient to avoid preventable poor outcomes, ED visits, and hospitalizations. In addition, remote monitoring empowers providers to be able to adjust medications through telehealth visits. Both patients and their providers to better visualize and understand blood sugar control trends and proactively prevent devastating long term complications of the disease.
Some preliminary studies demonstrate that RPM can benefit post-discharge patients with type 2 diabetes. Using RPM equipment at home, patients have demonstrated improvements in health outcomes, including decreased A1c levels.
Treating chronic conditions can be expensive. Remote Patient Monitoring is an effective tool that may help facilitate patient engagement to effectively manage chronic conditions.
Traditionally, patients have been tasked with tracking their own physiologic measurements, writing them down, waiting until they have an appointment, and then reading off handwritten readings to their doctor. This tedious process is rife with potential error and significant risk of non-compliance.
RPM simplifies the process by providing an opportunity to bring the management of a variety of chronic conditions into the modern era. Equipped with portable, easy-to-use connected devices, patients can take an active role in their treatment plans. With more regular engagement, physicians can help patients make greater long-term progress and reduce avoidable costly treatments.
1 The figures reflect the latest available 3rd party data. However, exact figures may vary depending on source, measurement methodology, and recency of data provided by designated governing association.