Personal insurance providers are increasingly integrating digital health tools into their coverage options, enabling patients to engage in more proactive management of chronic and acute conditions. Among these tools, remote monitoring technologies have become a cornerstone of modern healthcare delivery. These tools offer continuous, data-driven insights into patient health, allowing clinicians to assess physiological or self-reported data without requiring an in-person visit. As adoption grows, it is essential to understand who is using these services, for which conditions, and at what cost.
Defining Remote Monitoring: RPM and RTM
Remote monitoring typically falls into two main categories: Remote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM). RPM involves the electronic transmission of objective health data — such as blood pressure, blood glucose, or weight — from patients to healthcare providers. This data allows clinicians to identify early signs of deterioration or improvement and adjust treatment plans accordingly.
Conversely, RTM centers on self-reported data, such as pain levels, mobility, or adherence to treatment protocols. By enabling providers to track behavioral or functional progress, RTM complements RPM and supports a broader range of therapeutic interventions.
Analysis of Utilization Among Privately Insured Adults
A recent analysis using Merative™ MarketScan® Commercial Databases examined outpatient use of RPM and RTM among adults under 65 with employer-sponsored insurance. The study included data on 10.2 million adults with at least six months of coverage, extrapolated to represent approximately 102 million of the 165 million individuals with private employer-based insurance in the United States.
In 2023, about 300,000 adults — representing roughly 0.3% of all eligible enrollees — had at least one claim for remote monitoring services. Among those users, 93% participated in RPM programs, while 19% used RTM. A subset of patients utilized both services concurrently, reflecting the growing trend toward integrated remote care.
Conditions Monitored and Associated Costs
The data revealed that enrollees receiving RPM services most often had circulatory conditions, with 47% undergoing monitoring for cardiovascular health and 31% managing hypertension or related diseases. Meanwhile, RTM was primarily used for musculoskeletal disorders, accounting for 73% of RTM claims. Cost analysis indicated an average monthly expenditure of $55 per patient for RPM and $78 for RTM, highlighting a modest but meaningful investment in preventive and continuous care.
Variation in Coverage Across Insurers
Coverage policies for remote monitoring services vary considerably among commercial payers. Some insurers impose restrictions on eligible conditions or limit the duration of coverage, creating barriers to broader adoption. In contrast, Traditional Medicare offers a more inclusive approach, permitting RPM for any acute or chronic condition and RTM for musculoskeletal, respiratory, or behavioral health care. Despite tighter constraints in the commercial market, patterns of remote monitoring utilization — including the types of conditions treated and duration of engagement — mirror those observed under Medicare.
Implications for the Future of Personal Insurance
As digital health technology continues to evolve, personal insurance providers face growing pressure to adapt their benefit structures. Remote monitoring not only improves patient outcomes but also enhances cost efficiency by reducing hospital admissions and enabling early interventions. Understanding utilization trends and coverage disparities will be essential for shaping equitable access and fostering innovation in connected healthcare models.
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