Receipt of Out-of-State Telemedicine Visits Among Medicare Beneficiaries During the COVID-19 Pandemic

Abstract

IMPORTANCE Early in the COVID-19 pandemic, states implemented temporary changes allowing physicians without a license in their state to provide care to their residents. There is an ongoing debate at both the federal and state levels on whether to change licensure rules permanently to facilitate out-of-state telemedicine use. OBJECTIVETo describe out-of-state telemedicine use during the pandemic.

Takeaways From 2 Key Studies on Interstate Telehealth Use Among Medicare Fee-for-Service Beneficiaries

“…Third, both studies 1,3 demonstrate that interstate telehealth is primarily an issue of maintaining existing clinician-patient relationships. Although a small percentage of patients may seek new clinicians across state borders, most interstate health care we observed 3 consisted of established patient care.…”

“…Finally, both studies 1,3 show that patients who live in rural areas are more likely to receive care from an interstate clinician than those who live in nonrural areas. Mehrotra…”

“…et al1 found that, of This is an open access article distributed under the terms of the CC-BY License. a telehealth service, those who live in rural communities were more likely to receive interstate telehealth (34% vs 21%).…”

“…Similarly, Andino et al 3 reported that rural patients disproportionately received interstate telehealth care. These 2 studies1,3 indicate that interstate telehealth availability (1) is a key issue for many states, (2) disproportionately affects patients who live near state borders and/or in rural communities, and(3) affects established clinician-patient relationships more than new patient relationships. Given the nature of the interstate care that we have observed during the COVID-19 pandemic (a time when licensure rules were maximally relaxed), it is safe to say that policies that facilitate interstate telehealth should be prioritized.Policymaking for interstate telehealth is complex.…”

Errors in Header Text in Table 3

“…In the article titled “Receipt of Out-of-State Telemedicine Visits Among Medicare Beneficiaries During the COVID-19 Pandemic” 1 published on September 16, 2022, in JAMA Health Forum , there were errors in some of the header text in Table 3. In 4 places where it previously read “distance category” it now correctly reads “diagnosis category.” This article was corrected online.…”