---
title: "RPM Software vs. Fully Managed RPM: In-House or Outsourced?"
description: Explore the pros and cons of insourcing versus outsourcing remote patient monitoring to find the best model for your practice's needs and capabilities.
image: https://www.1bioshealth.com/hubfs/Screen%20Shot%202021-07-17%20at%2010.11.34%20AM.png
---
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# RPM Software vs. Fully Managed RPM: Which Model Fits Your Practice?
Author: [Andy Scott](https://www.1bioshealth.com/blog/author/andy-scott)
Last updated: September 23, 2026
Tags: [Remote Patient Monitoring (RPM)](https://www.1bioshealth.com/blog/tag/remote-patient-monitoring-rpm)
For a practice considering remote patient monitoring, choosing software is only part of the decision. Someone also needs to enroll patients, help them connect their devices, review readings, and follow up when something needs attention. **Software with internal staff fits practices that can own that daily work; hybrid delivery adds help with specific functions; fully managed RPM brings in a partner to run a broader agreed scope.** The right choice depends on your team’s capacity, the responsibilities you want to retain, and applicable payer requirements.
At[1bios](https://www.1bioshealth.com/), our approach starts with a simple idea: **You already have the patients. We bring the operation.** That means identifying the work your team needs help performing, alongside the technology that supports it. A useful RPM outsourcing decision starts with knowing what the partner will do and what your practice will continue to own.
[Discuss your RPM operating model with 1bios](https://www.1bioshealth.com/book-intro)
## At a glance: Which RPM operating model fits?
- **Software with internal staff:** Fits practices with the people and management capacity to run enrollment, device activation, reading review, outreach, and documentation.
- **Hybrid RPM:** Fits practices that want to retain selected functions while getting help with specific work, such as device logistics and connectivity troubleshooting.
- **Fully managed RPM:** Fits practices seeking a partner to operate a broader agreed scope, subject to the contract and applicable payer requirements.
In every model, the practice retains clinical direction and oversight. Compare total operating costs, including the work your employees will still perform. Ask who owns each task and the follow-up when something goes wrong.
## What separates RPM software from a managed operation?
**RPM software provides tools; a managed service assigns people to perform defined program functions.** A platform may organize device data, patient lists, work queues, and activity records, depending on its capabilities. Your operating model determines who acts on that information and resolves unfinished work.
Consider a patient whose device arrived but never transmitted a reading. Someone needs to determine whether the patient opened the package, understood the instructions, activated the device, or encountered a connection problem. Until a named person follows through, the practice has an enrolled patient without the expected monitoring data.
The same distinction applies later in the workflow. A reading can reach a dashboard without being reviewed, and an outreach attempt can be documented without resolving the patient’s concern. The operating model should specify who owns the next action and who checks that it happened.
## RPM operating models: Who does the work?
| Responsibility | Software with internal staff | Hybrid RPM example | Fully managed RPM |
| --- | --- | --- | --- |
| Patient enrollment | Practice manages outreach, participation discussions, consent workflow, and follow-up. | Partner supports outreach and onboarding; practice directs patient selection. | Partner runs the contracted enrollment workflow; practice directs patient selection. |
| Device delivery and activation | Practice coordinates fulfillment and helps patients begin transmitting. | Partner handles agreed shipping, setup, and activation support. | Partner coordinates delivery, setup, and activation within its scope. |
| Missing readings | Practice investigates gaps and follows through with the patient. | Partner investigates technical gaps; practice handles clinical concerns. | Partner investigates and follows through within scope, involving the practice when needed. |
| Connectivity problems | Practice troubleshoots with vendor support as contracted. | Partner handles technical troubleshooting and reports unresolved issues. | Partner coordinates contracted troubleshooting and resolution. |
| Reading review and patient outreach | Practice staff review readings and contact patients. | Practice staff retain clinical review and outreach. | Partner staff perform contracted review and outreach where permitted. |
| Escalation | Internal team routes concerns to designated clinicians. | Practice owns clinical escalation; partner routes concerns it identifies. | Partner follows approved routing; practice supplies the required clinical response. |
| Documentation | Practice records activities and checks completeness. | Each team records its work; practice reconciles the handoff. | Partner documents contracted work; practice verifies access and completeness. |
| Billing handoff | Practice assembles supporting records for billing review. | Partner supplies its records; practice coordinates billing review. | Partner supplies agreed billing support; claim submission depends on the contract. |
| Clinical direction and oversight | Practice directs care and manages its internal team. | Practice directs care and coordinates both teams. | Practice retains clinical direction and oversight of delegated work. |
The hybrid column illustrates a partner supporting onboarding and technical functions while practice staff retain clinical monitoring. Other divisions are possible. All arrangements depend on contracted scope and payer requirements applicable on the service date.
## How the three RPM models work
The traditional insource vs. outsource discussion can hide meaningful differences between service arrangements. Some practices need technology and logistics, while others need an ongoing team for patient-facing work. Define the work before deciding which label best describes the program.
### RPM software with internal staff
In this model, your practice uses an RPM platform and assigns its own staff to run the program. The team manages enrollment, activation follow-up, reading review, outreach, documentation, and coordination with billing, with vendor support as contracted. Your practice also owns scheduling, training, supervision, and coverage when employees are unavailable.
This model fits practices with an established monitoring or care-management team and a manager who can protect time for the work. It gives the organization direct control over patient communication and daily workflow changes. The main question is whether that capacity remains available during absences, staff turnover, and competing office demands.
### Hybrid RPM delivery
Hybrid RPM divides responsibilities between the practice and a partner. For example, a partner might manage device fulfillment, activation assistance, and connectivity troubleshooting while practice employees review readings and conduct clinical outreach. The agreement should distinguish technical support from clinical services and identify the owner of every handoff.
This model fits practices that already perform some functions well but have a specific operational gap. A strong internal clinical team may need help getting patients connected without needing an outside team to review their readings. Hybrid delivery becomes difficult when both teams can see an issue but neither is responsible for resolving it.
### Fully managed RPM
Fully managed RPM generally describes an arrangement in which a partner operates a broad, defined set of program functions. Depending on the agreement and applicable rules, that scope may include enrollment support, device logistics, monitoring activities, patient outreach, documentation, and billing support. The term itself does not establish coverage hours, response times, staffing qualifications, or claim-submission responsibilities.
This model can fit a practice with eligible patients but limited capacity to build and manage the daily operation. Its value depends on the partner taking responsibility for the actual work described in the contract. The practice still needs clinical leadership, a responsive escalation pathway, and an internal person who manages the relationship.
## Operational example: Who resolves missing readings?
A patient who previously transmitted blood pressure readings stops sending data. The team first needs to determine whether readings were not taken, were taken but not transmitted, or are missing because the patient’s circumstances changed. A missing reading should prompt investigation under the agreed workflow, without assuming either a technical fault or a clinical emergency.
With **software and internal staff**, a practice employee owns that investigation. The employee contacts the patient, checks the device workflow, and involves technical support when needed. If the conversation reveals a clinical concern, the employee routes it through the practice’s approved process.
In the **hybrid example** above, the partner investigates the transmission problem and documents the findings. Practice staff take over clinical questions or concerns that emerge during that contact. Both teams need to know when the handoff has been received and who remains responsible for the unresolved issue.
In a **fully managed arrangement**, the partner performs the investigation and follow-up included in its scope. The practice supplies the clinical response when the issue requires its clinicians. Resolution should be recorded, whether that means transmission resumes, a replacement is arranged, or the clinician decides the patient’s monitoring plan needs to change.
## How to compare total RPM operating costs
**Compare the cost of delivering the same scope of work across all three models.** A software quote and a managed-service quote usually represent different bundles of responsibilities. The useful comparison is each quoted price plus the labor, management, devices, support, and administration your practice still needs to fund.
### Include the work behind an internal program
An internal budget should include employee time, benefits, training, supervision, and backup coverage alongside platform and device expenses. Include the time spent contacting patients who have not activated devices, resolving connection problems, and preparing records for billing review. Existing employees’ time has a cost even when the practice does not add a new position.
### Identify what partner fees include
Ask a prospective partner to explain when charges begin and which activities, devices, and support services they cover. Clarify implementation charges, minimum commitments, replacement or return costs, and the treatment of inactive or discontinued patients. For hybrid and fully managed arrangements, add the cost of the work your practice retains, including provider responses and vendor oversight.
### Separate service delivery from collections
Documented activity, submitted claims, and collected reimbursement are different measures. Request the assumptions behind any financial projection, including payer mix, patient participation, applicable service requirements, denials, and patient balances. Use your own costs and contract terms to assess the model rather than assuming outsourcing is always cheaper or internal staffing is always more profitable.
## How to compare total RPM operating costs
| Cost category | Software with internal staff | Hybrid RPM | Fully managed RPM |
| --- | --- | --- | --- |
| Implementation and training | Include platform setup, workflow design, and internal training time. | Include vendor onboarding and the work of defining handoffs between teams. | Verify implementation fees and include retained practice onboarding time. |
| Platform, devices, and connectivity | Identify subscription, device, connectivity, and replacement charges. | Determine which costs are bundled and which are separate. | Verify what the service fee includes and any separate device or connectivity charges. |
| Fulfillment and technical support | Include staff time plus contracted shipping and support charges. | Include partner fees and internal time spent coordinating exceptions. | Verify included logistics and support, plus charges outside the agreed scope. |
| Program labor | Include enrollment, review, outreach, documentation, and administrative time. | Add retained internal labor to fees for outsourced functions. | Add provider responses and other retained work to partner fees. |
| Supervision and backup coverage | Include management, training, absences, and turnover. | Include internal coverage and coordination across both teams. | Include vendor oversight and verify the partner's coverage arrangements. |
| Billing administration | Include record review, claim submission, and denial follow-up. | Include record reconciliation and whichever billing tasks remain internal. | Verify included billing services and budget for tasks the practice retains. |
| Transition and exit | Include data transfer, training, and potential device changes. | Include changes to both internal and partner workflows. | Review termination terms, data export, device obligations, and handover costs. |
Compare the same scope of work across models and include retained practice costs. Bundled fees vary by agreement, so verify what each quote includes. Use practice-specific costs and contract terms rather than assumed prices or savings.
**Outsourcing RPM still leaves the practice responsible for clinical direction, appropriate patient selection, clinician responses, and oversight of delegated work.** The practice needs to approve workflows and ensure concerns reach someone who can act on them. The exact division of duties should be documented in the agreement and meet applicable requirements.
Agree on who receives escalations, how receipt is acknowledged, and what happens when the usual clinician is unavailable. Confirm actual service hours and the patient instructions used outside those hours instead of assuming that remote monitoring means continuous observation. Detailed abnormal-reading protocols should be developed separately for the practice’s clinical needs and staffing arrangement.
The practice also needs access to records that support care and billing review. Define where documentation lives, how discrepancies are corrected, and who is responsible for claim submission and denial follow-up. The phrase “billing support” is not enough to establish those responsibilities.
## What should you verify before switching RPM models?
Start with a list of active patients, devices, open issues, and the people currently responsible for them. Then test how each item will move to the proposed model. A transition plan should account for patients already receiving services as carefully as it accounts for new enrollment.
- **Service ownership:** Name the owner of each task, including unresolved technical problems and clinical handoffs.
- **Staffing and payer fit:** Verify who employs clinical staff, their qualifications, supervision arrangements, and how the model will meet rules applicable on the service date.
- **Device continuity:** Confirm compatibility, ownership, connectivity arrangements, replacement procedures, and whether patients will need new equipment.
- **Records and access:** Test how your clinicians and billing team will receive information. Verify the specific interface or transfer workflow rather than assuming EHR integration.
- **Patient communication:** Agree on who explains the change, what patients must do, and which contact number they should use.
- **Coverage and escalation:** Obtain the actual hours, response expectations, backup contacts, and procedures for unacknowledged concerns.
- **Billing transition:** Assign responsibility for each service period and supporting record, and check for duplicate billing during the handover.
- **Contract and exit terms:** Review fees, termination provisions, data export, device returns, and any work required if you change partners again.
Ask to walk through a sample patient record and an unresolved issue before approving the switch. Confirm that both teams can see the information needed to complete their assigned work. Set a handover date only after the remaining tasks have named owners and a plan for completion.
## How Medicare requirements affect the operating model
Under current[CMS remote monitoring guidance](https://www.cms.gov/files/document/mln901705-telehealth-remote-patient-monitoring.pdf), RPM involves established patients, medically necessary services, consent, and qualifying devices that automatically transmit data. Applicable requirements vary by service, including data collection and treatment-management requirements, so enrollment alone does not establish a billable service. The guidance also addresses general supervision and avoiding duplicate counting of time or effort when other care-management services are furnished.
Practices considering outsourced clinical staffing should also account for a potential change in Medicare policy. In its[proposed rule for 2027](https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2027-medicare-physician-fee-schedule-proposed-rule), CMS proposed allowing payment for RPM and RTM only when services are performed by clinical staff employed by the practice, rather than contractors. As of September 23, 2026, that change remains a proposal, so practices should distinguish current requirements from possible future restrictions and ask prospective partners how they would adapt if it is finalized.
These requirements belong in the operating-model discussion before a contract is signed. Identify who documents consent, verifies device and service requirements, maintains activity records, and supplies information for billing review. Check the rules for the practice’s setting and payers, and make sure the agreement can accommodate changes in final policy.
## Where 1bios fits
[1bios’s RPM offering](https://www.1bioshealth.com/solutions/remote-patient-monitoring-0) brings together technology, enrollment support, connected devices, care-team support, and billing assistance. Device logistics provide a concrete example: 1bios offers direct-to-patient shipping or bulk delivery to the practice, with devices pre-assigned and live setup support. These options address the work between selecting a patient for RPM and helping that patient begin using a connected device.
The right discussion starts with which parts of your program need an operating owner and which functions your practice wants to retain. Bring your current workflow and the gaps your team is trying to solve, such as patients who never activate a device or unresolved transmission problems. The proposed RPM agreement should define the service scope, staffing arrangement, clinical handoffs, and financial terms for your practice.
[BOOK A MEETING](https://www.1bioshealth.com/book-intro)
### Related articles
- [Why RPM and CCM programs stall](https://www.1bioshealth.com/blog/why-rpm-ccm-programs-fail)
- [Why RPM and CCM programs fail at enrollment](https://www.1bioshealth.com/blog/why-most-rpm-ccm-programs-fail-at-enrollment-and-how-to-fix-it)
- [In-house and outsourced chronic care management](https://www.1bioshealth.com/blog/outsourced-ccm)
## **Frequently asked questions**
RPM proposals can use similar language for very different service scopes. These answers clarify the distinctions that matter when comparing options. Use them alongside the responsibility comparison to identify questions your contract needs to answer.
### **What is RPM outsourcing?**
RPM outsourcing means contracting with an outside organization to perform specified remote patient monitoring functions. It can include logistics and technical support, or a broader set of services where permitted. The scope, clinical staffing structure, and retained practice responsibilities should be explicit in the agreement.
### **Can our practice buy RPM software and use its own staff?**
Yes, a practice can organize RPM around a platform and its own delivery team. It needs assigned staff for onboarding, ongoing review, patient outreach, documentation, and coordination with billing. It also needs management and backup coverage so the program does not depend on spare time or one employee.
### **Is fully managed RPM less expensive than running it internally?**
Neither model is automatically less expensive. Compare partner fees and retained practice costs with the full cost of staffing, technology, devices, supervision, and administration internally. The answer depends on your existing capacity, contracted scope, patient participation, and actual collections.
### **Does fully managed RPM include claim submission?**
Claim submission depends on the agreement. A partner may prepare supporting documentation without submitting claims, collecting payments, or working denials. Ask for each responsibility to be listed separately before comparing proposals.
### **Can we change models without replacing every patient’s device?**
That depends on the devices, platform compatibility, connectivity arrangements, and contract terms. Ask the outgoing and incoming teams to verify those details before promising patients a seamless transition. If equipment or setup must change, assign responsibility for delivery, training, and confirmation that readings resume.
[Andy Scott](https://www.1bioshealth.com/blog/author/andy-scott)
Andy Scott is the founder and CEO of 1bios, where technology, data, and care delivery come together to help patients and providers succeed. Over the past decade, he has built 1bios into a leading remote patient monitoring and virtual care management platform trusted by thousands of providers and hundreds of thousands of patients. His work helps healthcare organizations thrive while empowering patients to live healthier, more connected lives.
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### Related Articles:
#### [ RPM and CCM Billing: How Physician Practices Maximize Reimbursement](https://www.1bioshealth.com/blog/rpm-and-ccm-billing-guide-for-physician-practices-1bios)
#### [ Remote Monitoring Companies: How Physician Practices Choose the Right RPM Partner](https://www.1bioshealth.com/blog/remote-monitoring-companies-for-physician-practices-1bios)
#### [ How to Evaluate RPM Platforms for Small Practices: What to Look For](https://www.1bioshealth.com/blog/rpm-platform-small-practices)
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