SmartCare Health’s Turnkey RPM/CCM Services Provides 24/7 Chronic Disease Management with Zero Upfront Charge
There are more than 50 million Americans with multiple chronic diseases who qualify for – and would benefit from – Medicare-reimbursed remote patient monitoring. SmartCare Health allows healthcare facilities of all sizes to outsource this work, improving the daily care of complex patients while gaining a new line of revenue.
Written by Logan Plaster
Sometimes the highest impact innovations in healthcare are the least glamorous.
Sure, we love our shiny new wearables and AI assistants and stem cell research. But there is a lot of low hanging fruit in healthcare – both in terms of helping patients and building profitable businesses. The founder just needs to address a big enough market with a smart differentiation and rock solid execution.
That is the category where I would put SmartCare Health, a startup from Florida that is rethinking chronic disease care in the Medicare market.
The Challenge
The challenge SmartCare Health is addressing is well documented. We’re in the middle of a chronic disease crisis. According to the CDC, six in ten Americans have one chronic disease (such as diabetes, cardiovascular disease, and COPD) and 42% have two or more chronic diseases. Each year our population gets older, compounding the challenge.
We also have a healthcare system that is designed to keep patients at home until they have an emergency, and then funnel them to an expensive setting, like the emergency department or hospital ward. That’s the opposite of what a person needs when they’re battling multiple chronic conditions day in and day out.
Most of these people with multiple chronic diseases would benefit from being remotely monitored. It just makes sense. You’re better off catching a negative trend early and making small course corrections. That monitoring doesn’t have to be an expensive, futuristic device, either. A weight scale, continuous glucose monitor (CGM), and a blood pressure cuff can go a long way.
Medicare reimburses for remote patient monitoring (RPM) and chronic care management (CCM), if the patient meets a certain criteria. But even so, only a tiny fraction of the tens of millions of people eligible for RPM/CCM receive it. Why? There are two main reasons, and each helps explain how SmartCare Health came to be.
The first challenge in Medicare-reimbursed RPM is that the federal program just doesn’t pay that much. The codes for chronic disease RPM are around $50/month. Even operating at scale, that isn’t going to go very far if you want to hire skilled nurses to monitor health data and interact with patients. The codes for chronic disease CCM require expensive nursing time spent each month to obtain full reimbursement under Medicare.
The second challenge is logistics. Remotely monitoring thousands, and then hundreds of thousands, and then millions of patients requires an army of full-time healthcare providers. We are already facing a nursing shortage; amping up our RPM/CCM coverage will just put us over the edge. And that’s assuming a healthcare organization has the structural wherewithal to manage so many new employees.
In summary, chronic diseases are a massive problem, RPM/CCM can be incredibly effective at early intervention, Medicare reimburses RPM/CCM, but not enough for more than a tiny fraction of eligible patients to benefit from it using staffing available within their organization.
And that is precisely where SmartCare Health saw a win-win opportunity.
Origin Story
Keith Marks is a self-proclaimed “IT guy” with 35 years of experience in cloud computing and systems engineering. After a successful career in tech infrastructure, he teamed up with John LeBoeuf who had an equally long career in health insurance and nurse staffing.
The two found themselves musing about the broken healthcare industry and an idea began to form, one that nicely merged their 70 years of combined experience. What if they could build a company that provided remote monitoring for Medicare populations with chronic diseases with a 24/7 remote nursing care team?
“Too many companies focus on just the technology,” says Marks. “We wanted to combine the tech and the hands-on services in a way that was a win for everyone.”
There were two elements to their experience that Marks and LeBoeuf knew gave them a competitive advantage. The first was Marks’s decades of work in IT infrastructure. He knew that he could create a platform that was completely device agnostic, pulling in wireless health data from hundreds of different types of devices and processing it into one useful dashboard.
The second element came from LeBoeuf’s work running a healthcare staffing company that involved building a global nursing network. Specifically, he’d organized a large cadre of nurses who were trained and certified in the United States, but who lived overseas. He had direct access to a large pool of qualified US-licensed nurses who could be hired at a significantly lower hourly rate than their US-based counterparts. This global talent arbitrage was the financial key to providing 24/7 RPM care to patients at scale.
Next Steps
So far, the bet has paid off. SmartCare Health was launched in 2023 and by 2024 they’d already secured their first big accounts. They’ve got $7M under contract and 6,500 patients under their 24/7 care. They’re currently raising a round of financing that will help them scale.
They’re starting in Florida and are working their way north, but also have contracts in play in Connecticut and as far away as Hawaii.
“Only about five percent of the 2.3 million people in Florida who qualify for being monitored are actually being monitored today,” says Marks. He’s quick to add that SmartCare Health isn’t the only player in this market. But currently only around 100,000 people are getting monitored by the largest company in this space, and the need is north of 50 million. So there’s room for a lot of winners.
Their platform can pull in data from more than 400 FDA-cleared RPM devices, so whatever a physician prescribes, they can process. The platform also provides seamless bi-directional data that interfaces with the EHR systems in use by the physicians. They’ve got about 65 nurses on staff, and each can access HIPAA-secured data remotely. Each nurse monitors a specific set of patients, allowing them to build up trusted relationships with people who often just need a word of reassurance on the phone.
Between constant surveillance and 24/7 nursing support, the remote nursing staff can handle most situations that arise. When they can’t handle a situation, SmartCare has a second level of nursing help that is closer to the patient and actually has a relationship with the medical practice.
When Marks approaches healthcare clinics and hospitals about their offering, it’s a strong pitch. They are able to offer a turnkey program that doesn’t require any additional staffing on the client side. It also costs the client zero dollars up front. SmartCare Health analyzes the patient population, onboards the people who can benefit from their monitoring, the client’s EHR bills Medicare with data provided from SmartCare, and then splits those fees with SmartCare. Rather than an expense, it’s an added monthly recurring revenue line, a true win-win.
“We're not asking the physician to take any risk or any added costs,” says Marks.
Marks and his team are using a distinct competitive staffing advantage to take a big bite out of the massive RPM/CCM market. They’re off to a strong start and we’ll be excited to see how they scale in the year to come.
Join us in welcoming Keith Marks and the SmartCare Health team to the StartUp Health Access to Care Moonshot Community.
Connect with SmartCare Health via email
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Published: Feb 14, 2025
