Spertus Daniel, Abraham-Aggarwal Kiran, Unruh Mark Aaron, Yu Jiani, Bowles Kathryn H, Thompson Michael P, Espinosa Cisco, Jung Hye-Young, Sterling Madeline R
Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, LH-357, New York, NY, 10021, United States, 1 6469625029.
ILR School, Cornell University, Ithaca, NY, United States.
J Med Internet Res. 2025 Aug 7;27:e75861. doi: 10.2196/75861.
In the United States, the COVID-19 pandemic accelerated the adoption of telehealth in home health care (HHC), but its sustainability remains uncertain. Despite telehealth's potential benefits, including improved patient monitoring and expanded access, the lack of reimbursement and regulatory constraints may limit widespread adoption. Understanding how home health agencies (HHAs) perceive these challenges is critical for shaping future telehealth policy.
To examine HHA stakeholders' perspectives on the adoption, implementation, and sustainability of telehealth in the postpandemic era, with particular attention to operational benefits, financial and regulatory barriers, and the impact of new Centers for Medicare & Medicaid Services (CMS) billing codes (G-codes) for telehealth documentation.
Qualitative study using semistructured interviews conducted between February and December 2024. The study followed the Practical Implementation Sustainability Model (PRISM) framework for data collection and analysis. Participants were recruited from HHAs and home health policy organizations across the United States, representing a range of agency types and geographic regions. A purposive and snowball sampling strategy was used to recruit 14 stakeholders, including HHA leaders, HHC clinicians, and policy experts. Interviews were transcribed and analyzed thematically using both deductive codes from the PRISM framework and inductive codes to capture emergent themes. Participants described their experiences with telehealth in HHC, including its operational feasibility, clinical utility, financial impact, and response to new CMS G-codes introduced in July 2023 for telehealth documentation. Primary topics of focus included stakeholders' perceptions of telehealth's benefits, barriers, and future viability in HHC.
Stakeholders identified 4 key themes: (1) telehealth offers operational efficiencies (eg, increased patient touchpoints and workforce support) and clinical benefits (eg, improved patient monitoring and potential reduction in rehospitalizations); (2) the lack of CMS reimbursement makes telehealth adoption financially unsustainable for many HHAs; (3) specific HHAs, particularly those integrated with health systems or serving high-risk patient populations, may derive sufficient benefits to continue telehealth use despite financial constraints; and (4) current regulatory policies, including new CMS G-codes, increase administrative burden without providing financial incentives and discouraging telehealth adoption.
While stakeholders recognize the benefits of telehealth in HHC, financial and regulatory challenges pose substantial barriers to its sustainability. Policymakers must weigh the advantages of telehealth reimbursement and regulatory support against concerns about wasteful care.
在美国,新冠疫情加速了远程医疗在家庭医疗保健(HHC)中的应用,但其可持续性仍不确定。尽管远程医疗具有潜在益处,包括改善患者监测和扩大就医机会,但报销不足和监管限制可能会限制其广泛应用。了解家庭健康机构(HHA)如何看待这些挑战对于制定未来的远程医疗政策至关重要。
研究HHA利益相关者对疫情后时代远程医疗在HHC中的采用、实施和可持续性的看法,特别关注运营效益、财务和监管障碍,以及医疗保险和医疗补助服务中心(CMS)用于远程医疗记录的新计费代码(G代码)的影响。
2024年2月至12月进行的定性研究,采用半结构化访谈。该研究遵循实际实施可持续性模型(PRISM)框架进行数据收集和分析。参与者从美国各地的HHA和家庭健康政策组织中招募,代表了一系列机构类型和地理区域。采用目的抽样和滚雪球抽样策略招募了14名利益相关者,包括HHA负责人、HHC临床医生和政策专家。访谈进行了转录,并使用PRISM框架中的演绎代码和归纳代码进行主题分析,以捕捉新出现的主题。参与者描述了他们在HHC中使用远程医疗的经历,包括其运营可行性、临床效用、财务影响,以及对2023年7月引入的用于远程医疗记录的新CMS G代码的反应。主要关注的主题包括利益相关者对远程医疗在HHC中的益处、障碍和未来可行性的看法。
利益相关者确定了4个关键主题:(1)远程医疗提供运营效率(例如,增加患者接触点和劳动力支持)和临床益处(例如,改善患者监测和可能减少再住院率);(2)CMS报销不足使许多HHA在经济上无法持续采用远程医疗;(3)特定的HHA,特别是那些与医疗系统整合或服务于高风险患者群体的HHA,可能会获得足够的益处,尽管存在财务限制仍继续使用远程医疗;(4)当前的监管政策,包括新的CMS G代码,增加了行政负担,却没有提供经济激励,阻碍了远程医疗的采用。
虽然利益相关者认识到远程医疗在HHC中的益处,但财务和监管挑战对其可持续性构成了重大障碍。政策制定者必须权衡远程医疗报销和监管支持的优势与对浪费性医疗的担忧。