Insurance coverage is a significant barrier to accessing virtual pulmonary rehab programs for people with COPD.
RT’s Three Key Takeaways:
- Insurance Coverage Gap: A lack of in-network insurance coverage was the most cited reason for patients declining to enroll in virtual pulmonary rehabilitation programs.
- Access Equity: The study found that race, language, and socioeconomic vulnerability were not major barriers to enrollment, indicating that virtual options can reach diverse groups when covered.
- Reimbursement Expansion: Researchers are calling for broader telehealth coverage to help the more than 30 million Americans with COPD manage their symptoms.
Insurance coverage is a significant barrier to accessing virtual pulmonary rehab programs for people with COPD, according to a study published in the July 2026 issue of Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation.
COPD, which includes emphysema and chronic bronchitis, affects more than 30 million Americans and is the fourth leading cause of death globally. While research has proven the benefits of pulmonary rehabilitation—a supervised exercise and education program—it remains underutilized due to geographic limitations, comorbidities, and transportation challenges associated with in-person care.
To understand why virtual options do not always lead to increased enrollment, researchers analyzed 278 participants referred to a commercial virtual pulmonary rehabilitation program between July 1, 2023, and August 31, 2025. Of those referred, 45 individuals declined to enroll, with a lack of in-network insurance coverage cited as the most common reason.
The study found no statistically significant difference in demographics for those who enrolled versus those who did not. Factors such as social vulnerability, race, and language were not major barriers to enrollment, suggesting that virtual programs could improve healthcare equity if financial hurdles are addressed.
“While virtual pulmonary rehabilitation can help overcome geographic barriers to care, insurance coverage remains a significant and growing barrier for people who could benefit from these services. Importantly, we found that socioeconomic vulnerability, race, and language were not major barriers to enrollment in virtual pulmonary rehabilitation,” said Lauren E Eggert, senior author of the study and a physician at the University of California San Francisco.
The findings emphasize the necessity of policy adjustments to support remote respiratory care. “Our findings underscore the need to expand reimbursement for telehealth-based pulmonary rehabilitation so that more people with COPD can access this important component of care,” said Eggert in a news release.
