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Remote Patient Monitoring Adoption for Hypertension Management Among Medicare Beneficiaries
Donglan S Zhang1,2, Kai Hong3, Lisa M Pollack4
1Division of Health Services Research, Department of Foundations of Medicine, New York University Grossman Long Island School of Medicine, Mineola.
JAMA Network Open
|July 31, 2026
Summary
Switching to Medicare Advantage (MA) from fee-for-service (FFS) was linked to reduced remote patient monitoring (RPM) for hypertension and increased hospitalizations. Safeguards are needed during MA transitions to ensure continuous care and monitoring for hypertension patients.
Area of Science:
- Cardiovascular Health
- Health Services Research
- Health Policy
Background:
- Remote patient monitoring (RPM) aids hypertension management through self-measured blood pressure and telehealth.
- Continuity of RPM and care after transitioning from Medicare fee-for-service (FFS) to Medicare Advantage (MA) is not well understood.
Purpose of the Study:
- To compare RPM adoption, clinician continuity, and acute care use for hypertension in beneficiaries who stayed in FFS versus those who switched to MA plans (value-based contract [VBC] proxy or non-VBC).
Main Methods:
- Observational cohort study using Medicare data (2016-2022) with a difference-in-differences design and propensity score matching.
- Included adults aged 65+ with hypertension continuously enrolled in Medicare in 2018, comparing FFS beneficiaries with those switching to MA in 2019.
Main Results:
- Switching to MA was associated with lower RPM adoption (OR 0.55-0.73) and greater clinician loss (OR 1.09-1.27).
- MA switchers experienced higher rates of hypertension-related hospitalizations (OR 1.75-1.94) compared to FFS beneficiaries.
- Event-study analyses indicated divergence in outcomes post-transition through 2022.
Conclusions:
- Transitioning from Medicare FFS to MA was associated with decreased RPM use, increased clinician discontinuity, and higher acute care utilization for hypertension.
- Continuity safeguards and improved incentives during MA transitions are recommended to support RPM and follow-up care for hypertension.
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