Home health agencies drop telehealth, citing applicability, costs

New research reveals that home healthcare agencies are quitting telehealth, with one-fifth of the agencies that had implemented the virtual service during the COVID-19 pandemic discontinuing it in 2024.  

Reimbursement issues and uncertainty about whether telehealth is suitable for aging patients are driving the decision to discontinue telehealth, which could have ramifications for older adults' growing preference to age in place.  

The research published in Health Services Research details the results of a survey that polled home health agencies nationwide. Between October 2023 and November 2024, researchers sent the survey to 2,135 home health agencies, asking questions about telehealth adoption and discontinuation. They received 791 responses. 

An analysis of the survey results shows that a small percentage of home health agencies adopted telehealth between 2011 and 2019. In 2020, the adoption rate more than doubled to 26%, from 10.2% in 2019. 

Though telehealth adoption dropped to 7.2% in 2021, the cumulative percentage of agencies adopting telehealth by the end of the survey in 2024 reached 64.9%. However, 19% of home health agencies had also discontinued their telehealth services by 2024. 

More specifically, 9.3% of agencies discontinued virtual visits in 2021, rising to 22% in 2022 and beyond. Around 10% of agencies discontinued remote patient monitoring in 2021 and 8.6% in 2022 and after. 

The most common reason for discontinuing the services was that telehealth was inappropriate for their client population (60%), with respondents noting that "their patients tended to be older adults, often around 80 years old, not technology savvy, and preferred face-to-face visits to virtual interactions." 

More than half of survey respondents (55%) noted that costs and lack of reimbursement were the reason for abandoning telehealth, followed by challenges with integrating telehealth services into the workflow (16%), staff resistance (13%) and lack of staffing (10%). 

"This study is the first to provide a comprehensive national picture of telehealth's trajectory in home healthcare," said the study's corresponding author Dana B. Mukamel, Ph.D., distinguished professor of medicine, public health and nursing at the University of California, Irvine, in a news release. "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." 

Expanded federal reimbursement for telehealth services currently hangs in the balance. Pandemic-era waivers that offered Medicare telehealth reimbursement for rural health clinics and federally qualified health centers and coverage for audio-only telehealth, among other provisions, are set to expire at the end of September. The waivers were initially extended until March 30 after almost expiring at the end of 2024.   

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.