Insurance barriers may limit access to virtual pulmonary rehabilitation for people with COPD
New research suggests need for expanded telehealth coverage of programs
Miami (August 20, 2026) - Insurance coverage is a significant barrier to accessing virtual pulmonary rehabilitation programs for people with chronic obstructive pulmonary disease (COPD), according to a new study in the July 2026 issue of Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, a peer-reviewed, open access journal.
COPD, which includes emphysema and chronic bronchitis, affects more than 30 million Americans and is the fourth leading cause of death worldwide. People with COPD show improved outcomes when treatment includes a combination of pharmacotherapy, patient education, and pulmonary rehabilitation.
Pulmonary rehabilitation is an exercise and educational program supervised by health care professionals who teach people how to manage their symptoms and improve their quality of life. Programs are offered both in-person and virtually.
While research has proven the benefits of pulmonary rehabilitation, it is still underutilized in the management of COPD. Geographic limitations, comorbidities, and transportation challenges have shown to hinder access to in-person programs. Virtual pulmonary rehabilitation can help avoid these challenges.
This new study aimed to understand why the option of virtual pulmonary rehabilitation programs does not necessarily lead to an increase in enrollment despite people receiving appropriate referrals. Researchers compared participant characteristics of those enrolled in a commercial virtual pulmonary rehabilitation program with those who were referred but never enrolled.
From July 1, 2023 to August 31, 2025, 278 participants were referred to virtual pulmonary rehabilitation. Of those, 45 declined to enroll, with lack of in-network insurance coverage as the most cited reason. Study results did not show a statistically significant difference in demographics, including social vulnerability, for those enrolled in virtual pulmonary rehabilitation compared to those who did not enroll.
"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, M.D., of the University of California San Francisco and senior author of the study. "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."
To access current and past issues of Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, visit journal.copdfoundation.org.
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About the COPD Foundation
The COPD Foundation is a nonprofit organization whose mission is to help millions of people live longer and healthier lives by advancing research, advocacy, and awareness to stop COPD, bronchiectasis, and NTM lung disease. The Foundation does this through scientific research, education, advocacy, and awareness to prevent disease, slow progression, and find a cure. For more information, visit copdfoundation.org, or follow us on Twitter and LinkedIn.