Geographic regions that lacked access to cancer centers also had the lowest rates of telehealth utilization under Medicare, leading researchers to recommend greater policy efforts to expand telehealth access. The findings were presented at the 2023 ASCO Annual Meeting.

“Access to specialized cancer care varies by place of residence, partly due to differences in geographic proximity to designated cancer centers. Telehealth services can help alleviate some of these geographic disparities,” said Utkarsh Goel, Division of Hematology, Mayo Clinic, and coauthors.

Using Medicare Telehealth Trends data, the investigators determined what proportion of Medicare beneficiaries used telehealth throughout 2021, after access was expanded during the pandemic. These figures were then used to rank each state by the overall proportion of users, rural users, and urban users. 

Among members who were eligible for telehealth, the overall percentage of those who utilized the service ranged from 15% to 53% across states. Utilization ranged from 16% to 54% in rural areas and 14% to 54% in urban areas.

The states with the lowest overall percentage of telehealth users included Wyoming (20%), Montana (20%), Iowa (20%), South Dakota (18%), Nebraska (17%), and North Dakota (15%). Four of these six states did not have an in-state National Cancer Institute (NCI) Designated Cancer Center.

For members living in rural areas, the lowest utilization rates were found in Montana, Kansas, Iowa, Tennessee, and Wyoming (19% each), as well as South Dakota and Nebraska (16% each). Three of these did not have an in-state NCI Designated Cancer Center.

Regarding urban areas, Montana (20%), Wyoming (20%), Nebraska (19%), South Dakota (16%), and North Dakota (14%) had the lowest rates of telehealth utilization. Most (4 out of 5) had no in-state NCI Designated Cancer Center.

Researchers concluded telehealth utilization was lowest among Medicare beneficiaries living in the regions that lacked proximity to cancer centers, adding that “Advocacy and policy efforts directed towards increasing access to telehealth can ensure equitable and timely access to specialized cancer care in these regions of need.”

Reference:
Goel U, Gautam M, Gandhi S, Roy AM. Geographic disparities in Medicare telehealth utilization and access to specialized cancer care in the United States. J Clin Oncol. 2023;41(suppl 16; abstr e13683). doi:10.1200/JCO.2023.41.16_suppl.e13683