The U.S. healthcare system stands at a crossroads—facing both opportunity and constraint. On one hand, the Centers for Medicare & Medicaid Services (CMS) April 11 issued a proposed rule that would increase Medicare inpatient prospective payment system rates by a net 2.4% in fiscal year 2026, compared with FY 2025, for hospitals that are meaningful users of electronic health records and submit quality measure data. In addition, the American Medical Association (AMA) CPT Editorial Panel made recommendations to CMS to expand the number of CPT reimbursement codes for RPM. The recommendations are to add codes that reimburse for capturing fewer than 16 days of readings in a 30-day period and for performing less than 20 minutes of clinical review in a 30-day period, among others. These recommendations are typically enacted by CMS, so it is expected these new CPT codes will go into effect in January 2026.
On the other hand, however, Republican members of the House voted on April 10 to adopt a Senate-passed budget resolution that would provide over $5 trillion to extend tax cuts and fund other Trump Administration priorities while slashing at least $1.5 trillion in the federal budget through cuts to other federal programs, including Medicaid and the Supplemental Nutrition Assistance Program (SNAP). In addition, CMS also announced on April 11 that it will restrict federal funds for state-based programs that go toward certain priorities like rural broadband and student loan repayments. This would mean CMS rejecting, or not extending, federal matching fund requests for designated state health programs (DSHPs) and designated state investment programs (DSIPs) under section 1115 waiver authority.
While these developments may seem contradictory at first glance, they point to a deeper reality: healthcare systems must find cost-effective, outcome-driven strategies to do more with less. In this environment, RPM is emerging as a powerful tool—bridging the gap between constrained budgets and rising patient needs.
The Financial Squeeze: More Patients, Fewer Resources
The U.S. continues to face rising healthcare demands fueled by an aging population, increased prevalence of chronic conditions, and widening healthcare disparities. But cuts to Medicaid spending could be imminent.
At the same time, CMS sent a clear signal with its 2025 Physician Fee Schedule, which included expanded reimbursement for RPM and chronic care management. These increases acknowledge the role of remote monitoring in reducing hospital readmissions, improving outcomes, and managing chronic diseases more efficiently.
In short, while broader budgets are tightening, CMS is doubling down on care models that lower long-term costs—and RPM is at the top of that list.
Remote Patient Monitoring Is An Effective Clinical Resource
Remote patient monitoring allows clinicians to monitor real-time vitals and detect early signs of deterioration before an ER visit or hospitalization becomes necessary.
More than convenience, RPM has proven to be a transformational model for chronic disease management, particularly for conditions like:
- Diabetes
- Hypertension
- Congestive Heart Failure (CHF)
- Chronic Obstructive Pulmonary Disease (COPD)
These diseases represent some of the highest-cost burdens on Medicare and Medicaid—and RPM is uniquely positioned to help manage them more effectively.
Why RPM Matters Now More Than Ever
- Stretching Dollars Further
With Congressional budget cuts threatening essential services, every healthcare dollar must go further. RPM delivers measurable ROI by preventing avoidable hospitalizations and ER visits. According to the American Journal of Managed Care, RPM programs have reduced hospital admissions by as much as 38% in heart failure patients, and slashed healthcare costs per patient by over $7,000 annually.
This is the type of scalable, high-impact solution needed to offset budget constraints without compromising patient outcomes.
- Aligning with CMS
While discretionary funding is in danger of being decreased, CMS’s potential for increasing reimbursement for RPM services shows a strategic pivot toward value-based care. Under proposed CMS rules, providers can now bill for more frequent check-ins, data interpretation, and chronic care coordination using remote technologies.
This opens new revenue streams for providers who adopt RPM—offering both clinical benefits and financial incentives to stay ahead of the reimbursement curve.
- Closing Care Gaps
Budget cuts often hit public health programs and rural healthcare hardest. RPM helps fill those gaps by bringing care directly into the home, regardless of zip code. For underserved and rural populations, many of whom struggle with transportation or local provider shortages, RPM is not just a convenience, but a lifeline.
It also supports health equity by extending monitoring and follow-up services to populations that historically fall through the cracks of traditional healthcare systems.
- Lightening the Load on Overworked Providers
Staffing shortages remain a crisis point in American healthcare. With fewer nurses and overburdened primary care teams, provider burnout is real—and growing. RPM helps optimize care team efficiency by automating routine monitoring and triaging patient data so that clinicians focus on high-risk cases first.
In an era of workforce strain and budget cuts, RPM supports smarter, leaner care delivery without sacrificing quality.
Policy, Tech, and Patient Readiness Are Aligning
Several key factors are converging to make RPM a scalable solution, not just a buzzword.
- Policy Backing: CMS’s investment in RPM shows federal alignment with remote, home-based care.
- Technology Maturity: Devices are more accurate, affordable, and user-friendly than ever.
- Patient Adoption: Post-pandemic, patients are more open to remote care, with studies showing increased satisfaction with home monitoring over in-clinic visits for chronic disease management.
What was once an optional add-on is now a critical infrastructure tool for managing high-cost patient populations efficiently.
Final Thoughts: A Pivotal Moment
At first glance, the recent CMS proposed increases and federal healthcare budget cuts might seem at odds. But taken together, they point to a clear directive: We must move from reactive, expensive care to proactive, tech-enabled models that deliver better outcomes for less money.
Remote Patient Monitoring is exactly that model.
For policymakers, health systems, and technology partners, this is a moment of inflection. By embracing RPM, we can create a leaner, smarter, and more equitable healthcare system, one that thrives even when budgets tighten, so that patients still get the care they need, when they need it most.
