Home Health Nurses Say Telehealth Isn’t Working for All Elderly Patients
Telehealth usage surged during the COVID-19 pandemic, with home health agencies rapidly increasing adoption from just 23% in 2019 to 65% in 2021. However, as pandemic restrictions eased, recent studies reveal that many agencies are now scaling back on virtual care. This decline reflects patients’ renewed preference for in-person visits after relying heavily on video appointments.
The Money Talk: Why Agencies are Pulling the Plug
Recent national surveys show that 19% of home health agencies that adopted telehealth have since discontinued it. Among those, more than half cited high costs and lack of reimbursement as a key reason for stopping telehealth services. The Centers for Medicare & Medicaid Services (CMS) has not reimbursed home health agencies for telehealth visits, even as temporary waivers for other sectors were extended. This financial gap makes it difficult for agencies to justify continued investment in telehealth technology and personnel, especially when many of their clients are older adults who may also struggle with technology.
As one study summarized, “without CMS reimbursement, many agencies may abandon telehealth, potentially missing opportunities to improve care and manage costs as home health demand skyrockets”.
When Telehealth Leaves Older Patients Behind
Many home health agencies serving patients with cognitive impairments, such as dementia, have found that telehealth is often not well-suited to their clients’ needs. Research shows that older adults with dementia and other cognitive or sensory impairments frequently struggle to use technology independently, requiring significant assistance from caregivers or support staff. For example, studies indicate that as many as 82% of homebound older adults—nearly half of whom had dementia—needed help from family or paid caregivers to complete telehealth visits. These technological barriers can lead to increased stress and frustration for both patients and caregivers, rather than improving care delivery. Cognitive impairment is a well-documented risk factor for non-use of technology among older adults, and difficulties with hearing, vision, and digital literacy further compound the challenge.
Impact of Telehealth Reimbursement Changes on Nursing Roles
The reduction in telehealth reimbursement affects nurses by potentially increasing their workload as many return to more time-consuming in-person visits, while also limiting opportunities for remote patient engagement that some nurses found beneficial. Providing telehealth to patients with cognitive impairments presents challenges, as these patients often need additional assistance during virtual visits. Policy changes that support sustainable reimbursement and flexible care models could help maintain telehealth as a valuable option in home healthcare, enabling nurses to adapt care to individual patient needs. This situation also highlights the need for ongoing training and technical support to ensure nurses can effectively use telehealth tools when appropriate, maintaining quality care amidst changing healthcare delivery methods.
What's Next for Home Health and Telehealth?
The big question is, what does this mean for the future of home-based care? According to Harvard Medical School researchers, telemedicine is here to stay, but unless Congress steps in to extend those pandemic-era rules, millions might be left without this option
For nurses, this shift is significant. Many have put in the time and effort to master telehealth tools, only to see these programs fade away. The goal now is to remain adaptable and advocate for sustainable telehealth models.
Looking forward, the experts suggest that policy changes could breathe new life into telehealth. Ideas include establishing permanent reimbursement mechanisms for virtual visits, creating tech support for vulnerable populations, and developing hybrid care models that blend in-person and virtual visits based on patient needs.
In this evolving landscape, staying informed about telehealth policy changes and remaining flexible in care delivery will be crucial for nurses as the industry adapts to new challenges and opportunities.
🤔 Nurses, what do you think about this? Share your thoughts in the discussion forum below.
If you have a nursing news story that deserves to be heard, we want to amplify it to our massive community of millions of nurses! Get your story in front of Nurse.org Editors now - click here to fill out our quick submission form today!
