HootMD News Desk
One of the first large real-world RTM outcome studies tracked 831 patients and 51,265 assessments over 15 months. It lands as payers and clinics look for evidence that the CMS reimbursement program changes patient outcomes.
A new remote therapeutic monitoring (RTM) study has put hard numbers on a question the industry has been asking since 2022: does RTM make patients better? Based on 831 patients and 51,265 assessments, the answer is yes. For three years, clinics have adopted RTM largely on the promise of reimbursement and patient engagement. What has been missing is outcomes data at any real scale: proof that patients enrolled in these programs actually get better.
A new retrospective analysis by Actuvi is one of the first to close that gap. Actuvi conducted and published the analysis using 15 months of RTM program data collected with Arizona Pain, a multi-specialty pain clinic client in the Phoenix area. The study covers 831 patients and 51,265 individual assessments from January 2025 through March 2026.
Across that cohort, 72% of patients reached meaningful pain improvement, medication compliance climbed to 91%, and depression and anxiety fell even though no one in the study was being treated for mental health. This is one of the first datasets large enough to say something concrete about what RTM produces at the point of care.
Why an RTM study matters right now
The Centers for Medicare & Medicaid Services created RTM billing codes in 2022, letting clinics get reimbursed for tracking patient-reported data between visits. More than 100 million Americans live with those conditions, so the addressable population is large.
Payers have begun asking for proof that the monitoring changed outcomes rather than just generating claims, and there has been very little published remote therapeutic monitoring (RTM) research at scale to answer them. That is what makes this study worth attention. The reimbursement program has been live long enough to start showing outcomes, and someone finally measured them.
What the study measured
The analysis covered 831 patients who submitted 51,265 assessments over 15 months at a single clinic. Patients completed a daily pain assessment, a daily medication log, a weekly rehabilitation check, and a weekly pain progress tracker. For most measures, the researchers compared each patient’s earliest readings against their most recent ones, using a window of five to ten readings to smooth out daily noise and requiring a minimum number of entries per patient before including them.
Among patients with at least six responses, 72% achieved what the study defines as “meaningful improvement”: a drop of at least 1.5 points on a 10-point pain scale, confirmed by a follow-up reading at or below that level. The median time to hit that threshold was 10 days. The improvement did not stop at the first milestone. Among patients who responded early, 72% kept improving, adding another 1.5 points of relief on average. Patients who reached a 2-point reduction early in the program, the threshold clinicians use as the minimal clinically important difference, went on to average a 70% total pain reduction from baseline.
Three-quarters of responders held onto their gains at their most recent recorded reading, and the average patient’s peak improvement across the full monitoring period was 4.5 points, with 75% of patients hitting at least a 3-point peak reduction at some point.
Across the entire cohort, including patients who never engaged consistently, average pain dropped 8%. Narrow that to the 431 patients tracked for overall pain reduction, comparing their first five readings against their last five, and active responders averaged a 30% reduction.
Key findings at a glance
| Finding | Result | Patients analyzed |
| Meaningful pain improvement | 72% of patients; median 10 days to response | 486 |
| Significant pain improvement (1+ point) | 37% of patients | 431 |
| Engagement effect on major improvement | 5.2x more likely to reach the MCID (p < 0.0001) | 431 |
| Peak pain improvement | 4.5 points average; 75% reached 3+ points | 363 |
| Medication compliance | 91% across the cohort | 90 |
| Depression improved | 42% of patients | 248–264 |
| Anxiety improved | 43% of patients | 248–264 |
Engagement was the biggest lever, by a wide margin
The study splits patients into four compliance tiers based on how many responses they submitted: low, under 15; medium-low, 15 to 49; medium-high, 50 to 79; and high, 80 or more. The gap between the top and bottom tiers is stark.
Patients in the high-engagement group were 5.2 times more likely to reach the 2-point minimal clinically important difference than patients in the low-engagement group, with p < 0.0001 in the chi-square test. Fifty-nine percent of highly engaged patients showed measurable improvement, compared with 37% of low-engagement patients.
That finding lines up with what most RTM operators already suspect anecdotally: the technology only works if patients actually respond to it. What this study adds is a number to put behind that intuition, and a reason for clinics evaluating RTM to ask pointed questions about how a platform drives compliance, not just how it collects data.
Pain fell fast, and the gains held
Most responders improved early. The typical patient crossed the meaningful-improvement threshold in about 10 days. And the improvement did not stop there. Most initial responders kept getting better, and 75% of patients who improved still held their gains in their most recent readings.
Across all 431 patients in the pain analysis, average pain dropped 8%, a figure that includes everyone who stalled or worsened. Among responders, the average improvement was 30%. Measuring each patient’s best stretch, peak improvement averaged 4.5 points on the ten-point scale, and three in four patients hit a peak of at least three points at some stage. Only 2.6% of patients saw any major worsening.
Medication compliance reached 91%
Compliance across the cohort landed at 91%, and fewer than 7% of patients showed any decline over time. Missed medication is one of the most common reasons pain treatment fails, and getting patients to take what they were prescribed is a persistent problem in the field.
Remote monitoring of medication adherence that keeps compliance above 90% across hundreds of patients is a practical result clinics can act on.
Mental health improved without mental health treatment
The most unexpected finding had nothing to do with why patients enrolled. None of them were being treated for depression or anxiety. As their pain improved, both improved anyway. Depression scores got better for 42% of patients and anxiety for 43%, with responders averaging more than a 35% reduction in each.
The correlation with pain tracked almost exactly at the population level: pain and depression moved together at r = 0.94, and pain and anxiety at r = 0.96. Sample sizes for this portion ranged from 248 to 264 patients. Correlation is not causation, and the study does not claim RTM treats depression or anxiety directly. But for pain clinics that already know how tightly chronic pain and mental health are linked, having a concurrent data trail on both, collected through the same monitoring and assessment workflow, is a meaningful side benefit.
What It Means for Clinics Still Deciding on RTM
For clinics weighing whether to launch or expand an RTM program, the practical takeaway is less about the specific percentages and more about the shape of the curve: improvement tends to show up early, with a median of 10 days, it compounds for patients who stay engaged, and engagement itself is the variable that separates a 37% response rate from a 59% one. That puts the emphasis for any RTM rollout squarely on how a program gets patients to actually respond, not just how it captures and bills for the data that comes in.
As more clinics adopt RTM under the CMS framework, studies like this one will likely become the norm rather than the exception. The billing codes have existed since 2022. The outcomes data is only now starting to catch up.
Common questions about the RTM study
Where can I read the RTM research?
The full RTM study was published by Actuvi and is available at actuvi.com. It documents the methodology, sample sizes, and statistical tests behind each finding.
How large was the study?
The RTM research analyzed 831 patients and 51,265 assessments over 15 months at a multi-specialty pain clinic, one of the larger real-world RTM datasets reported to date.
What was the single most important finding?
Patient engagement. Highly engaged patients were 5.2 times more likely to reach a major pain-improvement milestone than the least engaged, the strongest effect in the study.
