The problem is having to make an item-by-item decision for thousands of items.

If the decision is just "dump", the problem become easy: you strip the house bare and throw it in a dumpster. There was a hoarder house near me that was cleaned out in a couple days that way - they parked a dumpster in the front yard, hired a couple guys to toss everything in the house in garbage bags and toss all the garbage bags in the dumpster, gutted it down to the studs, remodeled it, and sold it.

The trouble is it's hard to get the hoarder to agree to do that, that's part of the disorder over valuing items that are junk, and also depends on the severity of the hoard. Sometimes the intervention can happen before it's all rotted to junk and there is legitimately items worth selling or keeping in the mess and the person just needs help letting go of the volume of random crap.

I would not be surprised if they would be money ahead hiring someone to sort through all the "junk" and make the decisions. There likely are a lot of things that have value in the mix that got sent to the dump.