Outpatient Negative Pressure Wound Therapy with Remote Therapy Monitoring: A Retrospective Claims Analysis

Background: Patient non-adherence to homecare treatment poses an obstacle to wound healing that can incur additional costs and prolong care.

Purpose: This retrospective pilot study examines the potential time and cost savings associated with a remote therapy monitoring (RTM) program designed to improve negative pressure wound therapy (NPWT) adherence in the homecare setting.

Methods: Payor claims data of patients initiating NPWT with (n=199) or without (n=232) RTM between January 1 and June 30, 2017 were analyzed. Claims within 90-days of initial NPWT placement were included in the study. Wound-related claims were identified using ICD10 coding. If a wound ICD10 code appeared in the top three ICD10 claim codes, the cost for the entire claim was included as cost associated with the wound. Start and stop bill dates were collected from internal clinical progress reports to assess the length of therapy between patients with and without RTM. The two groups did not significantly differ in gender or wound type. RTM patients were significantly older (p<0.05), had a higher percentage with Medicare Advantage plans (p<0.01), and had a higher mean Charleston Comorbidity Index score (p<0.05) than non-RTM patients.

Results: For both groups, chronic wounds ($16,751, n=149) had higher 90-day wound-related costs than acute wounds ($9,015, n=215). The median length of NPWT for non-RTM and RTM patients was 32 and 27 days, respectively (p=0.0394). Mean 90-day wound-related costs for RTM and non-RTM patients were $10,515 and $12,158, respectively. Non-NPWT 90-day wound-related cost was $8,302 on average for non-RTM patients, in contrast to $6,893 for RTM patients.

Conclusion: These results build upon previous studies of RTM-assisted outpatient NPWT and suggest an opportunity for wound care cost savings.