MyBackHub · RTM Eligibility Explorer
MyBackHub · Internal Strategy Tool

RTM Eligibility Path Explorer

A teaching model of how a back-pain patient does — or doesn't — reach Remote Therapeutic Monitoring reimbursement. Branches route by primary payer; the Medicare branch now splits out dual eligibles. Percentages estimate how much of the population survives each gate. Real eligibility always requires the member's actual plan & plan ID.

Starting population
Credentialing scenario
Where the back-pain population lands
Cleanly reimbursable (Medicare FFS)
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…of which $0 to member · no waiver (dual eligible)
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Reimbursable w/ friction (MA + commercial)
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Total addressable RTM pool
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No near-term RTM path
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Outcome funnel — % of all starting back-pain adults
Each bar is the share of the entire starting population that ends at that verdict, after compounding every gate.
Every path, by coverage branch
Click a branch to expand. The % is the share of the entire starting population that travels that full path.
Assumptions & reasoning
Planning estimates, openly listed so the team can challenge or refine them. Structural figures (self-funded share, MA share, dual-eligible share, software-as-device, 2026 thresholds) are sourced; demographic splits are reasoned approximations for a back-pain cohort.