Study: 19% of home care providers discontinued telehealth post-pandemic, citing limited reimbursement

A new study from the University of California, Irvine, the University of Minnesota School of Public Health, and others found that many home healthcare companies that utilized telehealth during the rapid adoption spurred by the COVID-19 pandemic have stopped using the technology altogether. The findings are published in Health Services Research. [1]

The study, based on surveys conducted nationally, found that roughly 19% of home health providers stopped using telemedicine after the peak of the pandemic, citing a lack of federal reimbursement to justify the cost. Many reported that even during the pandemic, the Centers for Medicare & Medicaid Services (CMS) failed to reimburse patient care conducted through virtual care at rates comparable to in-person services.

The survey was conducted over a year, from October 2023 to November 2024, with 791 home care agencies invited to participate. Of them, 37% chose to respond, most of whom specialize in care for patients with significant cognitive impairment, such as dementia, who would benefit from remote care.

On average, 33% of patients seen by respondents have dementia or similar conditions.

Low Medicare reimbursement was only part of the reason many providers chose to drop telehealth. According to the study’s authors, ears over the technological literacy of patients were also a primary concern, given their cognitive impairment and advanced age.

“They elaborated 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. In fact, some felt very strongly that home health care cannot and should not be provided virtually as exemplified by one response provided in all capital letters: WE SEE PATIENTS IN THE HOME,” the study authors led by Dana B. Mukamel, PhD, from UC Irvine, wrote. 

“Home healthcare agencies also reported that patients shared the belief that home health should not be provided virtually—specifically, this was reported by 18% of [home healthcare agencies that never adopted telemedicine and 10% of those that later discontinued use],” the authors added.

Looking into adoption before the pandemic, 23% of responding home health care agencies said they had adopted telehealth by 2019. However, that number spiked to 65% by 2021, spurred by patients who were fearful of at-home care during the COVID pandemic. 

But now that things are relatively back to normal, adoption is decreasing again, signaling that many opted not to permanently adopt telemedicine, either for primary care or for follow-ups with patients.

The authors said prior to the pandemic, virtual care adoption was increasing organically. They wondered if “absent COVID-19, the diffusion process would have continued,” assuming CMS saw the value in the technology and developed a framework for reimbursement. 

“These are questions that we cannot answer, as COVID-19 interrupted the process. We do know that a substantial number of home healthcare agencies are still using telehealth at the end of 2024, despite the lack of reimbursement by CMS. If reimbursement does not occur, more home healthcare agencies may abandon telehealth eventually,” the authors stated. 

For agencies that did adopt telehealth but eliminated the option by 2022, 60% cited unsustainable demand as the reason, and 55% also said the lack of reimbursement was a determining factor.