Question: Our home care service has contracted to provide home-based telemonitoring for its congestive heart failure patients. There is a monthly fee that our organization has assumed for each patient. The patients are not billed for this service. Through the program, patients' symptoms are monitored daily (namely weight gain and breathing ability) and avoiding unnecessary hospitalizations due to heart failure complications. The program provides chronic disease management in the home and avoids acute care hospitalizations. Approximately 70 percent of home care agencies provide some type of telemonitoring service for their patients, and I assume the other agencies do not bill for these services, either. Would that place this service as more of a "standard of care," and not qualify for community benefit? There is no Medicare requirement to provide telemonitoring services.
Recommendation: The task force recommends not counting this telemonitoring program as community benefit for the following reasons:
- Monitoring home care patients by phone has become a standard of care.
- Offering telemonitoring could be considered a marketing tool.
- In the question, it appears that access to home care is not a problem. If this is true, subsidizing home care should not be counted as community benefit. However, if access was a problem for vulnerable populations, home care, if the overall program lost money, could be considered a subsidized service community benefit.