Over 500,000 homebound Australians are being denied telehealth services due to Medicare requirements that researchers say are failing the country’s most vulnerable patients.
New research from Flinders University reveals that current Medicare rules require most patients to see their GP in person within 12 months to qualify for telehealth rebates—a requirement that many homebound individuals cannot meet.
The study, published in Health & Social Care in the Community, represents the first global systematic review and meta-analysis examining telehealth effectiveness for homebound populations. It found telehealth reduces hospital visits, improves mental health outcomes and increases community connection.
“Telehealth is not just a convenience, it’s a lifeline,” said Dr Maria Alejandra Pinero de Plaza from Flinders University’s Caring Futures Institute, who led the research.
“Yet, despite its proven benefits, many Australians remain excluded from accessing telehealth services because of outdated Medicare requirements.”
The research demonstrates telehealth’s effectiveness in improving quality of life by reducing pain, enhancing mental health, and increasing social engagement. The service also helps alleviate depression, anxiety, and loneliness among homebound patients.
However, the current system creates barriers for those who need it most. Dr Pinero de Plaza emphasised the scope of the problem: “There are over half a million Australians who are homebound, and many of them are invisible in our health system.”
“Our research clearly demonstrates the effectiveness of telehealth, but the current system is failing the very people it was designed to help,” she said.
The study reveals misconceptions about Australia’s homebound population. Contrary to common assumptions, a 2020 Australian survey found many homebound individuals are not elderly but are likely to be women under 50. Common conditions include ME/CFS, advanced cancer, and severe mental illness.
One significant challenge is Australia’s lack of a national definition for homebound status. “One of the challenges is that Australia does not yet have a national definition of what it means to be homebound, and there is no consistent way to identify these individuals in routine data,” Dr Pinero de Plaza said.
“We need to improve data collection to support evidence-based and equitable reforms that would allow Medicare to implement a targeted exemption.”
The researchers are calling for specific policy changes, including removal of Medicare’s in-person requirement for homebound individuals and increased funding for telehealth services. They also advocate for formal data collection of homebound populations to ensure recognition in health policy.
Dr Pinero de Plaza stressed the daily impact of current restrictions: “Every day, homebound Australians are missing out on care that could help them live better, safer lives, but until Medicare rules are updated, thousands of Australians will continue to miss out.”
The findings have implications beyond Australia’s borders. “This finding is significant, not just for Australia but for all populations where telehealth can be made available,” she said.
“The message is clear: Telehealth works. It keeps people healthier, safer, and more connected. It saves health resources and improves lives and health policies around the world should ensure its accessibility.”
The research builds on ongoing work examining the invisibility and unmet needs of homebound Australians, including those with chronic illness, disability, or frailty. It stems from the Visibility and Technological Solutions for Frail, Homebound and Bedridden People research program at the Caring Futures Institute.
Telehealth services expanded dramatically during the COVID-19 pandemic and have become integral to healthcare systems globally. The research suggests that while the technology proves effective, policy frameworks must evolve to match its potential.
Ritchelle is a Content Producer for Healthcare Channel, Australia’s premier resource of information for healthcare.
