For exercise capacity and quality of life, the best available evidence finds little or no difference between pulmonary rehabilitation delivered remotely and the same program delivered in a hospital or clinic. More people finish the remote version. The harder question is not whether video works. It is what you are actually being signed up for, because “virtual pulmonary rehab” covers products that have very little in common.
The short answer
A 2021 Cochrane review of telerehabilitation for chronic respiratory disease pooled 15 studies covering 1,904 people with chronic lung disease. On walking distance and quality of life, it found “probably little or no difference between telerehabilitation and in-person pulmonary rehabilitation.” On safety, it reported that “no adverse effects of telerehabilitation were noted over and above any reported for in-person rehabilitation or no rehabilitation.”
The American Lung Association describes the same thing in plainer terms: pulmonary rehabilitation is usually an outpatient program based in a hospital or clinic, and “you may also be able to receive certain forms of pulmonary rehabilitation in your own home or online.”
What the evidence actually says
Exercise capacity and quality of life
These are the two outcomes pulmonary rehab is usually judged on: how far you can walk, and how much your breathing limits your daily life. On both, the Cochrane review found the remote and in-person groups landed in roughly the same place. That is the finding that matters most if you are weighing a drive to an outpatient program against a session at your kitchen table.
More people finish a remote program
This is the clearest difference the review found, and it favors remote delivery: “People were more likely to finish a full program of telerehabilitation compared to traditional pulmonary rehabilitation (93% compared to 70% completion).”
That gap matters more than it looks. A program only helps you if you complete it. Hospital programs run on weekday hours and require you to get there two or three times a week for weeks on end, which is exactly why so many working adults never start one or quietly drop out. We wrote about that problem separately in pulmonary rehab while working full time.
Where the evidence is thinner
Honest reading of the same review requires three caveats, and the review states them itself.
- Almost everyone studied had COPD. The review notes that 99% of the 1,904 participants had chronic obstructive pulmonary disease, so the evidence is strongest there and thinner for asthma, interstitial lung disease and long COVID.
- The certainty of the evidence was limited by the small number of studies.
- The telerehabilitation models varied a great deal between studies. The review pooled quite different things under one label, which is the whole reason the next section exists.
So the fair summary is this: remote delivery of pulmonary rehab is supported, and it is not a compromise on outcomes. It does not follow that every product marketed as virtual pulmonary rehab delivers what was studied.
Why “virtual” is not one thing
Three things vary between virtual programs, and they are worth asking about directly before you enroll anywhere.
Who is on the call
Pulmonary rehabilitation is respiratory care. The American Thoracic Society lists respiratory therapists among the clinicians on a rehab team, and the American Lung Association does the same. Some virtual programs put a licensed clinician on every session. Others use a health coach, or an app with a video library and periodic check-ins. Ask which one you are getting, and ask what license that person holds.
One to one, or a cohort
A group class on video is cheaper to run and suits people who are motivated by others. One to one means the session is built around your current ability and adjusted while it is happening. Several virtual providers run cohorts by default and treat individual attention as a paid upgrade. We compare the structures in group or one-on-one pulmonary rehab.
Billed to insurance, or sold to you
Some programs bill your health plan. Others sell a cash package or a monthly subscription, which means there is no claim, no explanation of benefits and no plan coverage behind it. This is a separate question from whether your plan covers rehab at all, which we cover in does insurance cover pulmonary rehab. How Bloom’s program is paid for, through insurance or out of pocket, is laid out in our pulmonary rehab coverage breakdown.
What a remote program cannot do
Nobody is physically in the room with you. A therapist on video can see you, talk you through a movement and stop the session, but cannot put a hand on your arm. That is a practical reason a remote program has to be selective about who is appropriate for it, and a reason the first session is spent establishing what you can currently do rather than pushing you. If your condition is unstable, or you need on-site monitoring, an in-person program is the right setting and any honest provider will tell you so.
How sessions work at Bloom
Every Bloom session is run by a licensed respiratory therapist, one to one, by video, from your home, and billed to your commercial insurance plan. Not a cohort, not a recorded video library, not a coach with a checklist.
The content follows the standard the specialty societies describe. The American Thoracic Society defines pulmonary rehab as “a treatment program comprised of individualized exercise, education, and support that helps you manage your breathing problems, increase your stamina (energy), and decrease your breathlessness,” with exercise sessions overseen by staff who “prepare an exercise program just for you.” That is what the therapist on your call is doing. There is nothing novel or experimental about the method. What is different is the delivery and who is delivering it.
On length, the American Thoracic Society notes that “most programs meet two or three times a week and programs can last eight to 12 weeks or more.” Your plan of care is set with your therapist and, where a referral is involved, with the physician treating your lung condition.
For a walkthrough of a first appointment, see what actually happens in a pulmonary rehab session.
Who Bloom treats
Bloom works with adults who have COPD, moderate to severe asthma, interstitial lung disease or pulmonary fibrosis, or long COVID. The American Thoracic Society lists all of these among the conditions that benefit from pulmonary rehabilitation.
Care is billed to commercial insurance, including Aetna, Cigna, Anthem BCBS, Horizon BCBS and UnitedHealthcare. Whether your specific plan covers it, and what your share would be, is something we check for you before anything is scheduled.
Frequently asked questions
For exercise capacity and quality of life, a 2021 Cochrane review of 15 studies and 1,904 people found probably little or no difference between telerehabilitation and in-person pulmonary rehabilitation, and no adverse effects beyond those reported for in-person rehab. The review also noted that 99% of participants had COPD, so the evidence is strongest for COPD.
Yes. The same Cochrane review reported a 93% completion rate for telerehabilitation compared with 70% for in-person rehabilitation. Since a program only helps if you complete it, that difference is one of the strongest practical arguments for remote delivery.
Bloom bills commercial insurance plans, including Aetna, Cigna, Anthem BCBS, Horizon BCBS and UnitedHealthcare. Coverage and your out-of-pocket share depend on your specific plan, so we verify both before anything is scheduled. Note that not every virtual provider bills insurance at all; some sell a cash package or monthly subscription instead.
A licensed respiratory therapist leads every session, one to one, by video. Pulmonary rehabilitation is respiratory care, and both the American Thoracic Society and the American Lung Association list respiratory therapists among the clinicians on a pulmonary rehabilitation team.
A device with a camera and a reliable internet connection, and enough clear floor space to stand and move safely. If anything else is needed for your particular plan of care, your respiratory therapist will go over it with you before your first session.
The American Thoracic Society notes that most programs meet two or three times a week and can last eight to 12 weeks or more. Your own plan of care is set with your respiratory therapist and, where a referral is involved, the physician treating your lung condition.
Yes. Nobody is physically in the room with you, so a remote program has to be selective. If your condition is unstable or you need on-site monitoring, an in-person program is the right setting, and we will tell you that rather than enroll you.
Find out whether you qualify
If you have COPD, moderate to severe asthma, interstitial lung disease, pulmonary fibrosis or long COVID and a commercial insurance plan, we can tell you in one short conversation whether one-to-one virtual pulmonary rehab is appropriate for you and what your plan covers.
Call 1-866-972-8228 to speak with someone about your plan and your symptoms.
Or complete the eligibility form and we will come back to you with what your insurance covers.
Sources
- Cox NS, Dal Corso S, Hansen H, McDonald CF, Hill CJ, Zanaboni P, Alison JA, O’Halloran P, Macdonald H, Holland AE. Telerehabilitation for chronic respiratory disease. Cochrane Database of Systematic Reviews, 2021, CD013040. Plain language summary.
- American Thoracic Society. Pulmonary Rehabilitation patient resources.
- American Lung Association. Pulmonary Rehabilitation.
