February 6th, 2026
By Sylvia Trujillo, MPP, JD and Emilia Ochoa-Ruiz, MS, PMP
Remote Patient Monitoring (RPM) has moved well beyond pilot programs and novelty use cases. It is now a core digital health strategy supporting chronic disease management, post-discharge care, and what many clinicians call “care between visits.” The Centers for Medicare & Medicaid Services (CMS) defines RPM as the use of connected medical devices that allow patients to collect and transmit physiological data, such as blood pressure, glucose levels, and weight, to their care teams for ongoing clinical management.
Yet while technology adoption has accelerated, many RPM programs struggle to move from short-term pilots into sustainable clinical service lines. The difference between programs that fade out and those that scale successfully is rarely the device itself. Instead, lasting success depends on whether RPM is designed as a repeatable clinical workflow with clear patient selection criteria, defined staffing roles, escalation protocols, and performance measurement.
Evidence Supports RPM, When Implemented Thoughtfully
Research continues to show RPM’s potential to improve outcomes and reduce healthcare utilization, particularly when programs are targeted and operationally supported rather than broadly deployed without structure. A systematic review and meta-analysis found that RPM may reduce hospitalizations and length of stay across several chronic conditions, although the certainty of evidence varied by outcome (Taylor et al., 2023). Similarly, a broader review of randomized controlled trials involving device-based remote monitoring found reductions in hospital service use in a significant portion of studies, with effectiveness closely tied to patient population and program design (Kruse et al., 2020).
The takeaway for health systems and clinics is clear: RPM works best when leaders define upfront what they are trying to prevent or improve, whether that is emergency department visits, readmissions, blood pressure control, or medication adherence. From there, workflows must be built to reliably detect changes in patient status and trigger timely clinical response.
The Five Non‑Negotiables of High‑Performing RPM Programs
- Clear patient selection: Define exactly who should be enrolled and for what clinical purpose.
- A defined clinical pathway: Specify what data is collected, which thresholds trigger outreach, how frequently data is reviewed, and how interventions occur.
- Staffing and coverage plans: Establish who monitors alerts, who contacts patients, who adjusts treatment plans, and how coverage works after hours.
- Strong patient onboarding: Provide training, language access, troubleshooting support, and clear expectations to promote engagement and confidence.
- Measurement and continuous improvement: Track clinical outcomes, patient engagement, staffing efficiency, and financial performance.
Designing for Reimbursement, Compliance, and Integrity
Financial sustainability and regulatory compliance should be built into RPM program design from the beginning, not added later. CMS recognizes RPM and Remote Therapeutic Monitoring (RTM) as distinct service categories, each with specific billing codes, documentation requirements, and clinical use cases.
At the same time, oversight agencies are paying close attention to rapid growth in RPM billing. The U.S. Department of Health and Human Services Office of Inspector General has highlighted concerns around potential fraud, waste, and abuse, including billing for patients without established clinical relationships and questionable device utilization practices.
Successful programs are those that maintain clear medical necessity, accurate documentation, transparent workflows, and audit‑ready operations, all while keeping patient benefit at the center.
Why Vendor Selection Matters More Than Ever
Technology partners play a critical role in operational success. However, selecting vendors based solely on dashboards or device features can lead to disappointing results. Practical considerations such as EHR integration, escalation workflows, device logistics, patient engagement tools, cybersecurity posture, training support, and responsiveness are what ultimately determine whether RPM fits into real clinical environments.
CTRC’s RPM Vendor Selection Toolkit and vendor evaluation checklists emphasize these operational realities, helping organizations avoid misalignment that can derail programs after launch.
Field Notes
- Post-discharge RPM for narrow populations such as heart failure or COPD often delivers the quickest impact when paired with nurse‑led escalation workflows.
- If no one can clearly identify who responds to alerts, the program is collecting data, not delivering care.
- Cellular‑enabled devices are critical for rural and low‑bandwidth communities.
Provider Lens
Rural Hospitals and Critical Access Hospitals (CAHs)
RPM can serve as a powerful capacity extender by stabilizing patients at home after discharge, reducing avoidable emergency visits, and supporting local clinicians managing complex cases. Programs should align RPM pathways directly with hospital pain points such as readmissions, frequent ED utilization, and transfer volume. Many rural systems are also integrating RPM into broader “virtual ward” models that combine telehealth check‑ins with home monitoring.
Rural Health Clinics (RHCs) and FQHCs/Community Health Centers (CHCs)
For outpatient safety‑net settings, RPM can strengthen team‑based chronic disease management, particularly for hypertension and diabetes. Continuous monitoring allows for faster medication adjustments and proactive coaching between visits. Programs should be designed around available care management resources, language access needs, and documentation standards, including state‑specific telehealth consent requirements.
Community Providers (Fee‑for‑Service Environments)
RPM can be financially viable in traditional reimbursement models, but sustainability depends on payer policies, strong documentation, and compliance oversight. Clear enrollment criteria, medical necessity justification, and audit‑ready workflows are essential.
Patient Corner
Remote monitoring can sometimes feel like extra work, so it is important for patients to understand how it benefits their care. If offered RPM, patients should feel comfortable asking:
- What data is being collected?
- How often are my readings reviewed?
- When will someone contact me if readings appear abnormal?
- What should I do if the device is not working properly?
If the program feels overwhelming or confusing, patients can ask about simpler monitoring plans or alternative check‑ins such as phone calls or in‑person visits.
CTRC Call to Action
- Download CTRC’s RPM Vendor Selection Toolkit to evaluate technology partners effectively
- Use CTRC’s Vendor Considerations Toolkit for contract and implementation planning
- Explore CTRC’s Sustainability Calculator for financial modeling, especially in clinic‑based programs
- Build staff expertise using CTRC’s training and course finder resources
References
- Centers for Medicare & Medicaid Services. (2023). Remote patient monitoring services. Remote Patient Monitoring – CMS
- Centers for Medicare & Medicaid Services. (2024). Remote therapeutic monitoring and RPM billing guidance. Physician Fee Schedule
- Kruse, C. S., Soma, M., Pulluri, D., Nemali, N. T., & Brooks, M. (2020). The effectiveness of telemedicine in the management of chronic disease. Journal of Medical Internet Research, 22(8), e17752. PubMed
- Taylor, M. L., Thomas, E. E., Snoswell, C. L., Smith, A. C., Caffery, L. J., & Scuffham, P. A. (2023). Does remote patient monitoring reduce hospital utilization? A systematic review and meta‑analysis. BMJ Open, 13(1), e063465. PubMed
- U.S. Department of Health and Human Services, Office of Inspector General. (2023). Medicare remote patient monitoring services: Program integrity risks and oversight considerations. OIG Reports
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