Telehealth seemed like a game-changer for home healthcare, but many agencies are hitting the brakes. Recent national surveys reveal that 19% of home health agencies that adopted telehealth have since stopped offering it. Why the sudden U-turn? A big reason is money: more than half of these agencies cited high costs and a lack of reimbursement. The Centers for Medicare & Medicaid Services (CMS) currently doesn't pay home health agencies for telehealth visits, creating a significant financial gap that makes it hard to justify the investment, especially when many older patients struggle with the technology.
As one study put it, 'without CMS reimbursement, many agencies may abandon telehealth, potentially missing opportunities to improve care and manage costs as home health demand skyrockets.' This financial pressure is pushing agencies to reconsider how they deliver care.
When Telehealth Leaves Older Patients Behind
The issue isn't just about money; it's also about patient suitability. Many home health agencies found that telehealth simply isn't well-suited for patients with cognitive impairments like dementia. Research consistently shows that older adults with cognitive or sensory challenges often can't use technology on their own. They need significant help from caregivers or support staff to even complete a virtual visit. For instance, studies found that as many as 82% of homebound older adults—nearly half with dementia—needed assistance with telehealth appointments.
These technological barriers can actually increase stress and frustration for both patients and their caregivers, rather than improving care. Difficulties with hearing, vision, and digital literacy only add to the challenge, making telehealth a poor fit for some of the most vulnerable patients.
How Telehealth Changes Affect Nurses
The reduction in telehealth reimbursement directly impacts home health nurses. Many are now seeing an increased workload as they return to more time-consuming in-person visits. While some nurses found remote patient engagement beneficial, these opportunities are now shrinking. Providing telehealth to patients with cognitive impairments already presented unique challenges for nurses, as these patients often required extra assistance during virtual visits.
This situation also highlights the need for ongoing training and technical support to ensure nurses can effectively use telehealth tools when they are appropriate. For quality care to continue amidst changing healthcare delivery methods, nurses need the right resources and adaptability.
What's Next for Home Health and Telehealth?
So, what does this mean for the future of home-based care? Experts, including Harvard Medical School researchers, believe telemedicine is here to stay. However, unless Congress steps in to make pandemic-era telehealth rules permanent, millions of patients might lose access to this care option.
For nurses, this shift is significant. Many invested time and effort into mastering telehealth, only to see programs disappear. The goal now is to remain adaptable and advocate for sustainable telehealth models. Looking ahead, experts suggest that policy changes could revitalize telehealth in home care. These ideas include:
- Establishing permanent reimbursement mechanisms for virtual visits.
- Creating tech support for vulnerable populations to overcome digital barriers.
- Developing hybrid care models that blend in-person and virtual visits based on individual patient needs.
In this evolving landscape, staying informed about telehealth policy changes and remaining flexible in how care is delivered will be essential for home health nurses as the industry adapts to new challenges and opportunities.
Source: Nurse.org | June 12, 2025