Transforming Care: The Impact of COVID-19 on Telehealth Adoption in U.S. Home Health Care Agencies

<b>Background:</b> The COVID-19 pandemic accelerated the adoption of telehealth in home health care (HHC). However, the extent and sustainability of telehealth use among Medicare-certified HHC agencies remain unclear. <b>Objective:</b> To examine the adoption and utilization of telehealth modalities among U.S. HHC agencies following the COVID-19 pandemic. <b>Methods:</b> A nationally representative survey of 474 Medicare-certified HHC agencies assessed telehealth use, modalities, and purposes, comparing adoption patterns between urban and rural agencies. <b>Results:</b> Overall, 69% of agencies used telehealth, primarily for care coordination, virtual visits, monitoring, and care initiation. Urban agencies more often adopted video-based modalities, whereas rural agencies relied on audio-only modalities, reflecting broadband access and digital infrastructure disparities. Although telehealth utilization increased during the pandemic, some agencies later discontinued use. <b>Conclusions:</b> Telehealth supplements HHC but remains fragile without Medicare reimbursement and a strong infrastructure. Targeted investments and reimbursement policies are critical for equitable, sustainable integration of telehealth in post-acute care.