Why Are Home Health Agencies Ditching Telehealth?

“Our findings suggest that without [Centers for Medicare & Medicaid Services] reimbursement, many agencies may abandon telehealth, potentially missing opportunities to improve care and manage costs as home health demand skyrockets,” Dana Mukamel, a UC Irvine Distinguished Professor of Medicine and corresponding author for the study, said in a press release.

According to the study, published online in Health Services Research, telehealth adoption among home health agencies stood at roughly 23% in 2019, then surged to 65% in 2021, during the height of the pandemic. By 2024, however, 19% of those organizations had opted to discontinue virtual care, due to a lack of Medicare reimbursement and concerns about sustainability.

“These patterns suggest that COVID-19 disrupted telehealth’s natural diffusion into home healthcare, which was gaining traction pre-pandemic,” the press release points out. “The study posits that without the pandemic, telehealth might have continued spreading as agencies recognized its benefits. However, the lack of reimbursement and perceptions of telehealth’s limitations for older adults pose barriers to sustained use.”

The study raises two important points.

First, many surveys have shown a decline in telehealth adoption after the pandemic, the inevitable result of patients wanting to get back in front of their doctors after relying almost exclusively on video visits. Telehealth advocates say this pendulum effect should wear off as both providers and patients understand the value of virtual visits and work toward a hybrid strategy that mixes in-person care and telehealth.

The monkey wrench in the works here is reimbursement. Federal and state lawmakers enacted a number of waivers during the pandemic to ease restrictions on telehealth use and boost coverage. While some states have moved to make pandemic-era conditions permanent, the federal waivers are set to end this fall. Many advocates fear that without those waivers, particularly those having to do with Medicare reimbursement, healthcare organizations will scale back their telehealth programs.

While aligning federal policy to improve telehealth reimbursement is a critical piece to telehealth strategy moving forward, the home healthcare industry also needs to rally around virtual care tools and platforms that are effective and intuitive. With health systems and hospitals looking to extend their services into the home, through remote patient monitoring, Hospital at Home and other strategies, they’ll need support from the home health industry to make those services effective and sustainable.