Program Cost and Return on Investment of a Remote Patient Monitoring Program for Hypertension Management.

Objective: 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. Study Design: 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. Methods: 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. Results: 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. Conclusions: 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.