2015 brought some interesting developments for mHealth – the introduction of Medicare’s Chronic Care Management (CCM) program with reimbursement for non-face-to-face care, the inception of Comprehensive Care for Joint Replacement (CJR) in November of 2015, increasing focus on personalized medicine & population health, and increasing presence of health data exchange & mHealth marketplace vendors.
Chronic Care Management
Medicare’s ruling for the CCM and CJR program provided opportunities for practices to capitalize on providing care remotely while receiving reimbursement. Traditionally, practices and hospitals suffered from barriers such as difficulty in being reimbursed for telemedicine. However, new Medicare programs have begun paving way for a more official acceptance by the larger healthcare community. Reimbursement by Medicare will subsequently encourage private insurance providers to embrace mHealth and telemedicine are part of normal care.
As the CCM program moves into its second year with increasing adoption by practices. It will continue to offer mHealth startups the chance to develop and deploy solutions that provide personalized care under a program that targets population health. Considering the minimal adoption within the first year and the frantic rush by some mHealth companies to capitalize on CCM, we are likely to see changing trends for tackling CCM. Companies may not see it as the gold rush for mHealth but a trajectory to pursue to deploy and validate their solutions.
Last year highlighted challenges faced by physicians with CCM, some of the major issues were: numerous complexities that need to be resolved such as tracking the time spent for non-face-to-face care, lengthy documentation to submit to Medicare, the $42 monthly reimbursement is not enough for many practices to break even, and many practices are unaware of the program.
Hopefully the lessons learned from 2015 will lead to changes in the CCM structure (including reporting and the fee) and increasing awareness among practices. The continual learning curve will change how mHealth solutions will be to adapt.
Population Health and Personalized Care
CCM and CJR are good examples of targeting specific populations for managing health and recovery. Combined, CCM and CJR population numbers around 37 million. Of course adoption by millions of patients would take many years but steps are being taken in the right direction. A rapid shift in telemedicine is now leading from individual care to individual care as part of a larger population will slowly emerge as a new healthcare ecosystem.
Personalized individual care via mHealth solutions will see greater adoption for follow-up care. Additionally, merging of personal health & fitness data along with data from ‘standardized’ medical apps for remote care will be another interesting thing to look out for – creating a bigger picture of an individual and not just as a patient. A new emerging concept will involve the use of behavioral data synthesized with health data for robust assessment of individual health and lifestyle. Multiply that on a larger scale and fantastic results can be achieved.
Greater Interconnectedness within Health IT
Of course, the topics discussed above aren’t developing in some sort of vacuum. A foundation for growth of mHealth and population health is necessitated with robust capabilities to acquire, access, and exchange data. Focus thus far has been predominately on using mHealth in isolation or integrating with the different EHR’s used by various practices and hospitals. Such silo approach tends to create protectionist behavior and offering little in the way of an integrated healthcare system.
This gap in the healthcare system has led to companies emerging (albeit few at the moment) offering a marketplace for apps and wearables as well as exchange of data between the user and the recipient. Such companies not only bridge the gap that exists, but become the central node for exchange and dissemination of technology and data overriding the barriers resulting from EHR vendors and Hospital IT infrastructure. While this sector relatively new, its growing need and importance will form a critical leverage needed by mHealth companies. Existing companies will see substantia growth and new companies will emerge in a relatively underserved market.
These three broad categories will be the areas of growth for mHealth in 2016 providing opportunities for both established and startups to venture into. These growth will provide benefits not only to mHealth developers but to hospitals & practices as well. More importantly, 2016 may see growth in a more connected Health IT ecosystem spanning the patient, Medical staff, and hospitals & practices.