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The Limber Health Story

Updated: May 1

Limber was started by my brother, Michael, and I in 2019. We were passionate about improving musculoskeletal care by integrating digital care with existing in-person MSK care networks.


I am a Sports Medicine Physician and the Co-Founder and Chief Medical Officer at Limber Health. My passion for Limber stemmed from working on innovative alternative payment models that could transform healthcare payment delivery for musculoskeletal care.


With the help of the AMA, AAPM&R, APTA, and many other stakeholders I helped create the new remote therapeutic monitoring(RTM) CPT codes for physicians, physical therapists, and occupational therapists which were approved by Medicare in January of 2022.


RTM


The original goals of RTM were to improve rehabilitation therapy adherence, as evidence demonstrates that early and adherent therapy improves clinical outcomes and decreases downstream healthcare costs as illustrated by many studies by Julie Fritz.


RTM can shift the healthcare system to a more value-based approach by connecting in clinic-care with care at home or virtually anywhere, measuring patient reported outcomes across episodes, improving access to therapy that may otherwise be unavailable, and reducing unnecessary expensive services, such as surgeries, opioids, MRIs.

Studies have shown that early and adherent therapy can decrease downstream healthcare costs by 60% per episode. It can decrease ED admissions (ex. low back pain), reduce unnecessary MRIs, opioids, exacerbations of episodes, and reduce unnecessary surgeries. RTM has been used as a glide path to innovative alternative payment models as they are improving therapy adherence, maximizing conservative care, and tracking objective quality measures such as pain and function during the episode.

On average in the US, only 12% of patients that are prescribed to in-person rehabilitative therapy go to therapy, and of those that attend, less than 30% complete their prescribed therapy sessions. Additionally, it is universally agreed by physicians and physical therapists that for patients to have the best recovery, it is critically important they stick with their recommended home exercise regimen in between their in-person visits. However, research shows that less than 35% of patients adhere to their home exercise program. We found the challenges include access to care, time constraints and compliance, and cost barriers.

Patients need additional tools and support to drive therapy adherence. RTM provides a pathway to improve home exercise therapy adherence by offering digital and engaging home exercise programs monitored by a physician or physical/occupational therapist.

Why is RTM and digital technology needed for us to move to a value-based care system?

I have been excited about the ability to use digital tools to improve MSK care as an outreach of in-person care and had a goal to make these tools widely available. This is especially important as musculoskeletal conditions are the most prevalent chronic condition, impacting 1 in 2 adults each year. It is the number one cost driver for employers in the U.S.

Today, providers have limited access to real-time data to track their patients’ adherence, pain, and function levels. I firmly believe that providers need more digital tools to follow evidence based musculoskeletal care to appropriately evaluate improvement.

Here is some information on the new Remote Therapeutic Monitoring codes:

There are four new codes that can be used for remotely monitoring MSK care, including:

98975: Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on use of equipment

98977: Remote therapeutic monitoring (e.g., respiratory system, musculoskeletal system status, therapy adherence, therapy response; device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal system, each 30 days

98980: Remote therapeutic monitoring treatment management services, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes

98981: Remote therapeutic monitoring treatment management services, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; each additional 20 minutes (list separately in addition to code for primary procedure)

Remote therapeutic monitoring with Limber Health is a valuable tool for improving patient outcomes. By allowing patients to monitor their health indicators remotely and communicate with their healthcare provider, patients can receive more personalized care and improve their overall health. As remote monitoring technology continues to advance, we can expect to see even more benefits for patients and healthcare providers.




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