‘missed Opportunity’: 19% Of Telehealth-equipped Home Health Agencies Drop Virtual Care

Many home health agencies (HHAs) adopted telehealth during the COVID-19 pandemic, but the tool is increasingly falling out of favor.

Of the total number of HHAs offering telehealth, 19% stopped using the technology by the end of 2024, according to a new study published in Health Services Research. The majority, 14%, of these HHAs were those who adopted telehealth after the onset of the COVID-19 pandemic. More HHAs may discontinue use unless the U.S. Centers for Medicare & Medicaid Services (CMS) reimburses and incentivizes HHAs’ use of telehealth technologies, according to the study.

“We do know that a substantial number of HHAs are still using telehealth at the end of 2024, despite the lack of reimbursement by CMS,” the study’s authors wrote. “ If reimbursement does not occur, more HHAs may abandon telehealth eventually. If telehealth, however, is cost-effective and leads to better patient outcomes, as some claim, this will be a missed opportunity.”

Researchers sent surveys to a national sample of 2,135 HHAs, asking if and when they adopted telehealth, if and when they discontinued telehealth and why they decided to start or stop offering telehealth. The National Association for Home Care & Hospice and the Forum of State Associations of Home Health Agencies expressed their support for the surveys in letters to the surveyed HHAs.

Of the chosen HHAs, 791 submitted responses. Few HHAs had adopted telehealth before 2020, but the adoption rate increased from 10.2% in 2019 to 26% in 2020. At its peak, 65% of HHAs had adopted telehealth.

The top reason for not adopting telehealth or discontinuing its use was that telehealth was not appropriate for the HHA’s client base.

“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,” researchers wrote. “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.”’

Costs and lack of reimbursement were the second most commonly cited reasons.

Over half of HHAs still used telehealth at the end of 2024, but the number of HHAs that will continue to offer telehealth depends on Medicare reimbursement policies and information about cost-effectiveness, researchers wrote.

“Rigorous evaluations of the effects of telehealth in home health on costs and patient outcomes are needed, and if home health telehealth turns out to be cost-effective, CMS should adopt a reimbursement policy and incentives that support HHAs’ use of telehealth technologies, especially as the expenditures of home health are expected to continue to grow by over 10% per year in the coming decade,” researchers wrote.

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