Return on Investment (ROI) of Remote Patient Monitoring (RPM): A Complete Guide for ACOs and Healthcare Organizations

The U.S. healthcare system continues its transition from fee-for-service models to value-based care, prompting healthcare organizations to rethink how they deliver care and measure outcomes. For Accountable Care Organizations (ACOs) and large integrated health systems, the ability to balance cost savings and quality improvements is vital to sustaining such models over the long run.

Remote Patient Monitoring (RPM) has become one of the most effective mechanisms to achieve this balance. An RPM program gives providers the ability to extend care into the home, so they can monitor those patients with chronic conditions continuously; therefore, they can intervene sooner and prevent avoidable hospitalizations.

However, the most puzzling question that still needs to be answered is: What is the ROI of RPM?

For ACOs, ROI is not just about the revenue collected from Medicare billing codes; it’s about how RPM improves performance in value-based contracts by reducing the total cost of care and creating shared savings.

This blog will explain ROI for RPM in detail, including: Financial Reimbursements, Cost Savings, Operational Savings, Adoption, Payer-specific Considerations, and Future Outlook.

The Current Status of RPM in Today’s Healthcare Model in the US

Remote Patient Monitoring has witnessed quite a significant acceleration across the country. In 2025, there are more than 30 million patients utilizing some aspect of RPM technology, and it’s expected to escalate at a rate of as much as 15–20% annually. The Center for Medicare and Medicaid Services (CMS) has created clear reimbursement plans, which demonstrate the federal government’s commitment to expanding digital health.

• 85% of large hospitals are now using some form of RPM, but the uptake of RPM across ACO and physician groups has been more sporadic.
• ACOs are responsible for the total cost of care through the Medicare Shared Savings Program (MSSP).
• RPM allows ACOs to mitigate avoidable ER visits, readmissions, and high-cost hospitalizations, which enhances their shared savings.
• As more contracts shift to capitation and risk-sharing, RPM provides a platform to manage populations better and proactively.

For ACOs, this deployment of RPM is particularly strategic. In many cases, RPM is the most effective way to do this, as RPM allows clinicians to recognize issues before they escalate, resulting in reduced visits to the emergency department and improved overall performance on quality metrics.

What is the ROI in RPM- Types, Factors, & How It’s Calculated?

ROI in healthcare cannot be derived solely from a financial standpoint. For ACOs and healthcare organizations, it creates ROI in three distinct value streams: financial, clinical, and strategic.

1. Financial ROI: Financial ROI consists of direct ROI from billing direct and indirect ROI from billing CPT codes covering the RPM services that monthly billable generate a recurring monthly billable revenue stream for the providers and Indirect ROI through lower readmissions and ER visits, or better quality measures improving shared savings distributions.

• • Direct revenue from billing via the CPT codes.
  • Avoided costs through lower utilization.
  • Bonus money from shared savings or quality programs.

2. Clinical ROI: Clinical ROI is equally valuable. RPM aids patients with hypertension, diabetes, congestive heart failure, and COPD to stay on track and manage their disease. It keeps patients within target ranges, increases compliance with medication, and reviews their conditions early on, which data have shown improved outcomes.

• • Better chronic disease outcomes (BP, HbA1c, COPD, etc.)
  • Fewer hospitalizations or complications.
  • Better adherence and engagement.

3. Strategic ROI: Strategic ROI includes the less tangible but significant benefits mentioned earlier. RPM adoption exemplifies leadership in digital health, builds patient loyalty, and gives organizations data they can use to inform population health programs as needed. These intangibles could be the key differentiators:

• • Competitive advantage in digital health readiness
  • Enhanced patient retention and loyalty
  • Data to steer population health management efforts

Important Factors Impacting RPM ROI

There are a number of factors that impact the ROI of RPM, the most significant being patient selection, technology costs, staffing model, payer mix, and clinical outcomes.

1. Patient Population: Organizations that identify and include eligible patients, typically those with pertinent chronic conditions (hypertension, CHF, COPD, diabetes) and high utilization will experience the best financial and clinical results. Dual-eligible (Medicaid + Medicare) populations and high-risk groups have the most savings potential.

2. Technology Costs: Technology costs must also be accounted for. Programs must weigh the cost of FDA-approved devices and the cost of software licensing against reimbursement and cost avoidance. Leasing devices or working with vendors who have a bundled device-as-a-service model will help lower upfront investment and improve ROI analysis.

• • FDA-approved devices (BP monitors, scales, oximeters).
  • Platform licensing, integration costs.
  • Options to explore: purchase/ lease/vendor-provided.

3. Staffing Model: Staffing models can heavily influence program success. RPM programs reliant on physicians will drive costs and may become cost-prohibitive. Programs that can train nurses, MAs, or care coordinators to be responsible for day-to-day monitoring will be more sustainable. Using automation, alerts, and dashboards will also help minimize staff burden.

• • ROI is better by using non-physician staff (nurses, MAs, care coordinators) to do day-to-day monitoring.
  • One nurse can usually take care of 75-150 patients effectively and would be assisted by automation.

4. Reimbursement & Payer Mix: In the end, if the payer mix and outcomes were to equal a return on investment (ROI), you would expect Medicare fee-for-service patients to have the most reliable repayment, and while the same cannot necessarily be said for Medicaid and commercial, as they vary by payer and state. However, diminished costs in terms of ROI measuring outcomes such as blood pressure control, weight maintenance, and better adherence will increase if the outcomes directly lessen expensive acute care episodes.

• • Medicare group- Define codes (99453, 99454, 99457, 99458)
  • Medicaid group- Relies entirely on the state.
  • Commercial Payer- Not consistent across payers or states; however, this group is also developing coverage.

Billing and Reimbursement: The Direct Return on Investment for RPM

Medicare is making RPM financially friendly through a list of RPM CPT Codes that include:

• 99453 – Setup & education: CPT 99453 is for patient onboarding and education and will be billed one time per patient for approximately $19.
• 99454 – Device supply & transmission: CPT 99454 will reimburse approximately $54 monthly for the supply of the device and data transmission.
• 99457 – 20 minutes of monitoring & care management: CPT 99457 will reimburse approximately $50 per month for interactive monitoring and care management for the first 20 minutes.
• 99458 – Each extra 20 minutes: CPT 99458 will allow you to charge an additional $40 for each 20 minutes.

On average, that translates to $104 to $144 per patient monthly or $1,200 to $1,700 annually. For a program with 500 enrolled patients, that potential revenue translates to $625,000 to $750,000 annually. Similarly, larger programs can register higher revenues; a program with 1,000 enrolled patients can generate hundreds of dollars in reimbursement, resulting in annual reimbursement revenues well over $1.2 million.

Payer-Specific ROI Considerations for a Successful RPM Program

Medicare expects a straightforward ROI path based on established CPT billing and consistent reimbursement. As every state makes its own decisions about Medicaid coverage and reimbursement, ACO members reported variable ROI, while states with parity laws could have ROI similar to Medicare. Commercial payers continue to be inconsistent, although many are adding coverage for RPM as part of their population health programs.

1. Medicare Fee-for-Service

• • The most reliable reimbursement.
  • Direct CPM revenue + indirect value through readmission avoidance.

2. Medicaid

• • Coverage is state-based.
  • The strongest ROI is with state Medicaid programs that allow parity for RPM billing.

3. Commercial

• • Starts to add coverage, but inconsistency.
  • Some plans tie RPM into care management or value-based care incentives.

4. ACO & Risk-Based Contracts

• • ROI does not appear tied to CPT billing, but total cost of care reduction.
  • RPM will foster leverage in negotiations with payers.

For ACOs and organizations under risk-based contracts, ROI is less about RPM billing and more about total cost of care reduction. In these models, that leverage will assist ACOs to achieve a higher percentage of shared savings payouts by showing they reduced utilization and improved outcomes, thus lowering costs.

Step-by-Step Process of Implementing RPM for Higher ROI

To effectively implement RPM, ACOs and healthcare providers need a methodical and managed process that includes the following steps:

Step 1: Define Goals: Revenue generation? Cost reduction? Quality improvement? The first step in the process is to define goals: is the primary goal TRACTION to generate new revenue, reduce hospitalizations, improve quality metrics, or a mix of the three?

Step 2: Identify Target Populations: Start with chronic high-cost patients. From your goals, identify the populations of patients for whom RPM would most likely be effective within your organization’s capability, and those are chronic, episodic, high-risk patients.

Step 3: Choose Technology Vendor: This step includes choosing FDA-approved RPM devices that can prove HIPAA compliance and develop EHR integration. One of the most important steps is potentially selecting a technology partner, as the vendor needs to be compliant at least with FDA-cleared devices, HIPAA compliance, and EHR integration capabilities.

Step 4: Design Workflows: Define roles, deploy automated alerts, and establish test/sick protocols. Once you select a vendor, you will design workflows such that monitoring will be no more than a responsibility for someone other than a physician (at least for the routine monitoring) and provide a protocol for what to do in the case of abnormal readings.

Step 5: Educate Patients & Staff: Patient education is essential for compliance, and education/training for the entire staff is necessary to document proper time for billing.

Step 6: Monitor Outcomes: Identify financial (e.g., revenue, savings) and clinical metrics (e.g., metrics). The last essential step is to track both financial and clinical outcomes continuously, so that organizations can modify their enrollment decisions and staff ratios over time as the program grows.

Clinical Case Study: RPM ROI in Action

Case: Urban ACO (MDChronic) with CHF patients

MDChronic, an urban ACO monitoring 500 patients with CHF, reported better outcomes. By decreasing readmissions, the organization saved over $1.2 million per year and realized an additional $750,000 through reimbursement revenue. The combined ROI was $2 million annually, both reinforcing a positive financial position and advancing patient outcomes.

• Monitored 500 CHF patients.
• Save $1.2M on reduction in readmissions.
• Combined with reimbursement ($750,000), brought total ROI was> $2M on an annual basis.

Best Practices for Maximizing ROI in RPM

1. Implement RPM with high-cost, high-risk patients: If ACOs are to launch RPM with those patients that lead to the highest healthcare expenditure, patients with congestive heart failure (CHF), COPD, diabetes, and multi-morbidity are the ones to enroll. ACOs will be able to measure an immediate financial impact on a high-risk population. They target the least expensive 5–10% of patients who cost the most, thus allowing them to demonstrate metrics around decreased ER visits, readmissions, and acute exacerbations, to demonstrate ROI.

2. Leverage non-physician staff for monitoring: To control costs of program management and supervision, ACOs can delegate responsibility to nurses, care coordinators, or medical assistants instead of physicians. The non-physicians do the primary data review, along with outreach to patients related to program achievement, and activate escalation protocols, with physicians brought in only for clinically directed decision making.

3. Collaborate RPM with Chronic Care Management and Remote Therapeutic Monitoring : Collaborating Remote Patient Monitoring (RPM) with Chronic Care Management (CCM) and Remote Therapeutic Monitoring (RTM) generates complementary billable opportunities while creating a holistic care model. For instance, a diabetic patient enrolled in CCM can receive RPM for glucose levels and RTM for adherence to a therapeutic regimen. In addition to obtaining higher patient outcomes, bundling creates more revenue per patient with minimal addition to overall cost.

4. Use a real-world dataset to negotiate with payers: The ACOs that can present payers with a record of avoided admissions, eliminated readmission penalties, or enhanced quality performance scores can become a valuable negotiating partner. By providing data, ACOs can negotiate more favorable reimbursement rates for RPM, and inclusion either directly in value-based contracts or shared savings bonuses. Realizing a return on investment through demonstrated results and evidence-based ROI provides alignment with explorers for RPM instead of only a clinical enhancement.

5. Track ROI beyond dollars: While financial return is important, ACOs should also assess whether RPM affects care quality, patient experience, and provider satisfaction. Better patient-reported outcomes and engagement scores can drive better results in value-based care programs; therefore, taking a total ROI perspective highlights RPM as not only a revenue driver but also a way to achieve the Quadruple Aim of healthcare.

6. Scale incrementally after the ROI is implemented: The best practice is to start small, with a pilot group, and prove clinical, financial, and ROI results before rolling out RPM, rather than trying to roll it out to the entire patient population all at once. This way, the organization can use the pilot to improve workflows, ensure staff competency with training, and also technology integration. Scaling gradually helps demonstrate sustainability and reduces the chance of failure.

The Future of Remote Patient Monitoring- How Will It Impact the ROI

As we look ahead, the ROI of RPM will only continue to build. The advent of AI will allow RPM platforms to offer predictive analytics, allowing clinicians to intervene even sooner. CMS will continue to add reimbursements for RPM, particularly in areas like behavioral health and therapeutic monitoring.

Commercial payers will acquire more mandates from RPM and broaden reimbursement for chronic conditions. Data interoperability will improve, allowing RPM data to feed into population health platforms increasingly, thereby becoming one of the foundational aspects of ACO strategy.

Remote Patient Monitoring is one of the most effective tools to achieve the goals of value-based care and is multi-dimensional:

1) Direct reimbursement for RPM services from Medicare codes

2) Indirect cost savings from avoided hospitalizations

3) Improved quality scores that allow more shared savings payouts, and

4) Strategic imperatives that will improve patient loyalty and your competitive standing.

For organizations that share risk and contracts to improve value in care (i.e., ACOs, risk contracts, etc.) RPM is not just an add-on capability; it is a strategic requirement in the modern-day healthcare scenario.

How HealthArc Helps Maximize RPM ROI?

HealthArc is a leading digital health platform that helps healthcare organizations, Accountable Care Organizations (ACOs), and physician groups deliver smarter, value-based care. As experts in Remote Patient Monitoring (RPM), Remote Therapeutic Monitoring (RTM), and Chronic Care Management (CCM), HealthArc offers an all-in-one platform that takes the complexity out of patient engagement, compliance, and reimbursement.

It offers a seamless ecosystem with FDA-approved connected devices, easy-to-use patient apps, and built-in AI dashboards that integrate directly with existing EHRs. This allows care teams to spend less time worrying about administration and more time delivering proactive, data-driven care.

1. End-to-End RPM Platform with FDA-Approved Devices
2. Streamlined Billing Support, Reimbursement Billing
3. Use non-physician nationally trained staff to manage costs
4. Integration with CCM & RTM Programs
5. Population Health Insights with Data
6. Patient Engagement Capacity
7. Scalable, Future-Proof Infrastructure

Are you ready to implement Remote Patient Monitoring in a way that is profitable, scalable, and patient-centered? With HealthArc, ACOs and healthcare organizations can effectively cut readmissions, improve quality measures, and discover new revenue streams, all while providing better outcomes for the populations that need it the most.

Schedule a demo and see how HealthArc can help you maximize ROI and accelerate your value-based care approach.

FAQs on ROI of Remote Patient Monitoring (RPM)