Amid a flurry of telehealth activity, no certainty about its future

Stop us if you’ve heard this before, but telehealth appears to be on unstable footing yet again. The culprits in 2025 are both old and new, with the seemingly annual debate about Medicare reimbursement flexibilities joined by documentation frustration, the threat of weight-loss drug discounts, and a major insurer’s about-face on remote monitoring reimbursement. Through it all, a key question remains: Do patients even like telehealth? 

Let’s unpack how things have shaken out recently. 

Temporary flexibilities are temporary again. The end of the government shutdown extended Medicare flexibilities for telehealth reimbursement until Jan. 30. (The hospital at home program received a similar extension.) According to the Centers for Medicare & Medicaid Services, organizations will be reimbursed for telehealth services provided during the shutdown. But there’s no guarantee the flexibilities – already temporarily extended twice in the last year – will last in the long run. 

Documentation could become a burden. Under the latest CMS physician fee schedule, physicians must list their physical location when billing for telehealth visits as of Jan. 1. This requires enrolling for each location where they provide telehealth, including their home address if applicable. Along with raising privacy concerns, this would be an administrative headache for large health systems forced to verify hundreds of addresses – all for a service with arguably limited return on investment. 

Remote monitoring is under the microscope. Though the 2026 fee schedule touts the benefits of chronic disease treatment, UnitedHealthcare is curtailing coverage of remote patient monitoring of many chronic conditions under Medicare Advantage (AM). The insurer will cover RPM for chronic heart failure and hypertensive disorders of pregnancy but has eliminated coverage for common conditions such as diabetes, COPD, hypertension in the general population, and mental health. The move faces clinical and legal questions. 

Direct-to-consumer brands face competition. The Trump administration’s recent deal with Eli Lilly and Novo Nordisk cuts the monthly cost of glucagon-like peptide-1 agonist weight-loss medications to roughly $350; it’s part of an agreement for both manufacturers to begin developing oral versions of GLP-1s. A Forbes analysis found notable telehealth brands charging up to $500 per month for access to GLP-1s have lost their pricing advantage – though those offering weight-loss coaching may be in better shape. 

The reimbursement pause hurt utilization. Not surprisingly, telehealth utilization dropped roughly 20% during the early stages of the government shutdown, compared to the prior three months. Lack of Medicare and MA reimbursement played a pivotal role in this decline, Brown University researchers concluded. That said, they expressed concerns that temporary flexibilities (in lieu of permanent policies) would cause long-term disruption to access to care and further declines in utilization. 

Through it all, patients remain skeptical. A survey of Massachusetts residents this summer found 37% of patients had no telehealth appointments in the previous year – this despite nearly 94% of Bay State hospitals having some sort of telehealth service in place. Patients with higher incomes were actually more likely to use in-person care more frequently than those with lower incomes, though it’s unclear if that’s a byproduct of access to telehealth services or care delivery preferences.  

For more than a decade, telehealth has faced a Catch-22: Utilization has remained low thanks to limited availability and reimbursement, while stakeholders have argued against increasing availability and reimbursement because utilization has remained low. As 2025 draws to an end, nothing appears to indicate the path to sustainability – let alone growth – for telehealth is any clearer than in previous years.

Brian Eastwood is a Boston-based writer with more than 10 years of experience covering healthcare IT and healthcare delivery. He also writes about enterprise IT, consumer technology, and corporate leadership.