From AVIA’s Center for Care Transformation: Remote Patient Monitoring in the Safety Net – What Payers and Providers Need to Know


Treatment and prevention of chronic illness threatens to overwhelm California’s health care safety net — the provider and payer organizations that serve people with low incomes. Long stressed by workforce shortages, the safety net is under increasing strain due to the rising prevalence of chronic conditions such as heart disease and diabetes in the patient population

Encouraged by positive experiences with telehealth modalities during the COVID-19 pandemic, providers and payers are interested in additional ways to use technology for greater efficiency and access, including to facilitate chronic condition care and prevention.

To do so, some providers across the health care spectrum have incorporated remote patient monitoring (RPM) into their workflows. RPM is a type of telehealth that involves the secure transfer of personal health and medical data to a provider for remote monitoring, care, and support. Although not yet widely used among California’s safety-net providers — in part because of current Medicaid reimbursement policy — RPM offers potential for mitigating access barriers and facilitating care management for patients who have chronic conditions or who have warning signs of such illnesses.

Providers see the potential for RPM to improve connections with patients outside clinic walls, integrate services across the continuum of care, maximize workforce efficiency, expand access to care, and reduce health inequities.

This report, created by AVIA’s Center for Care Transformation and the Public Health Institute, includes a landscape scan of some of the available tools geared to chronic condition management. The research was done between November 2020 and February 2021 in an extremely fast-evolving marketplace, so the information shown is not complete. The report addresses several questions:

  • What problems can RPM help solve?
  • What do providers want and need from RPM?
  • What are patients’ needs and perspectives?
  • How is RPM currently reimbursed in Medicaid and Medicare?
  • What should providers know about starting or scaling up a program?
  • What is the outlook for RPM in the safety net?
  • What is the landscape of emerging companies focused on RPM?

Download the white paper