Telehealth Use by Home Health Agencies Before, During, and After COVID-19

Objective: To examine telehealth adoption and discontinuation by home health agencies (HHAs) during the COVID-19 pandemic in the context of telehealth pre-pandemic diffusion into the industry and its continued use once the pandemic abated. Study Setting and Design: HHAs nationally, serving the most patients with dementia (averaging 33% of the agency's patients) were surveyed during October 2023 to November 2024. Key variables included the agency's adoption and discontinuation of specific telehealth technologies by year, the reasons for discontinuation, and the reasons for not adopting any telehealth technology, either before or during the pandemic. Data Sources and Analytic Sample: Data were collected via a web-based survey with telephone follow-ups. We received 791 responses (37% response-rate) and provide descriptive statistics of responses and graphics. Principal Findings: By 2019, prior to COVID-19, 183 (23%) of HHAs used telehealth, increasing to 446 (56%) by 2021. Growth occurred mainly in virtual visits. Of those HHAs adopting telehealth, 96 (19%) discontinued use later in the pandemic. Key concerns were about the appropriateness of the patient population and reimbursement. Conclusions: Patterns of adoption and discontinuation suggest that COVID-19 interrupted the innovation diffusion process of telehealth into home health. Telehealth's future will depend on information about cost-effectiveness and Medicare reimbursement policies.