Zhang Donglan Stacy, Millet Laure, Bellows Brandon K, Lee Sarah, Mann Devin
Center for Population Health and Health Services Research, Department of Foundations of Medicine, New York University Grossman Long Island School of Medicine, Mineola, NY.
Department of Population Health, New York University Grossman School of Medicine, New York, NY.
medRxiv. 2025 Jan 29:2025.01.29.25321334. doi: 10.1101/2025.01.29.25321334.
To evaluate the program costs and financial sustainability of a remote patient monitoring for hypertension (RPM-HTN) program implemented in the cardiology practice of a large healthcare system.
This economic evaluation utilized field observation, interviews, literature review, and quantitative analysis to assess RPM-HTN from March to June 2024 at New York University Langone Health.
A costing tool was developed to quantify program costs, including personnel, start-up, equipment, and supply expenses, expressed in 2024 USD. Reimbursement rates were estimated using the 2024 Medicare Physician Fee Schedule. The return on investment (ROI) was calculated as the ratio of net return to program costs. Univariate sensitivity analyses evaluated the impact of varying a single parameter at a time on ROI.
The average cost of RPM-HTN was $330 per patient (range: $208-$452), with an annual program cost of $33,000 (range: $20,785-$45,168) for 100 patients enrolled from the Cardiology Division. Key expenses included data review by nurse practitioners ($172/patient), blood pressure device costs ($48/patient), and nurse-patient communication ($36/patient). ROI averaged 22.2% at 55% patient compliance with the RPM-HTN program. This ROI ranged from -11.1% (assuming program costs of $452) to 93.3% (assuming program costs of $208) per patient. ROI was most sensitive to changes in data review costs, insurance reimbursement, patient compliance, and device setup.
The RPM-HTN program demonstrated positive ROI, indicating financial sustainability in a large urban healthcare system. Improving patient compliance with the program and reducing human resource costs are critical for scaling RPM-HTN programs effectively.
评估在一个大型医疗系统的心脏病科实施的高血压远程患者监测（RPM-HTN）项目的项目成本和财务可持续性。
这项经济评估于2024年3月至6月在纽约大学朗格尼健康中心利用实地观察、访谈、文献综述和定量分析对RPM-HTN进行评估。
开发了一种成本核算工具来量化项目成本，包括人员、启动、设备和供应费用，以2024年美元表示。报销率使用2024年医疗保险医师费率表进行估算。投资回报率（ROI）计算为净回报与项目成本的比率。单因素敏感性分析评估一次改变单个参数对ROI的影响。
RPM-HTN的平均成本为每位患者330美元（范围：208美元至452美元），对于心脏病科登记的100名患者，年度项目成本为33,000美元（范围：20,785美元至45,168美元）。主要费用包括执业护士的数据审查（172美元/患者）、血压设备成本（48美元/患者）和护士与患者的沟通（36美元/患者）。在55%的患者遵守RPM-HTN项目的情况下，ROI平均为22.2%。每位患者的该ROI范围从-11.1%（假设项目成本为452美元）到93.3%（假设项目成本为208美元）。ROI对数据审查成本、保险报销、患者依从性和设备设置的变化最为敏感。
RPM-HTN项目显示出正的ROI，表明在大型城市医疗系统中具有财务可持续性。提高患者对该项目的依从性和降低人力资源成本对于有效扩大RPM-HTN项目至关重要。
