JAMA Health Forum: Receipt of Out-of-State Telemedicine Visits Among Medicare Beneficiaries During the COVID-19 Pandemic

JAMA Health Forum: Receipt of Out-of-State Telemedicine Visits Among Medicare Beneficiaries During the COVID-19 Pandemic

This study analyzed out-of-state telemedicine use among Medicare beneficiaries during the first half of 2021. The study found that nearly 40 percent of out-of-state visits were for primary care, while 25 percent were for mental health. Researchers found that most visits across state lines are part of an established provider-patient relationship, and that restrictions on out-of-state care may disrupt many existing patient-clinician relationships in primary care and mental health treatment. The findings suggest that licensure restrictions of out-of-state telemedicine would have had the largest effect on patients who lived near a state border, those in rural locales, and those who received primary care or mental health treatment.

Other key findings from the study include:

Of the 8,392,092 patients with a telehealth visit, 422,547 patients (5 percent) had one or more out-of-state telemedicine visits.
In 62.6 percent of all out-of-state visits, a prior in-person visit occurred between the same patient and clinician between March 2019 and the visit, showing that out-of-state telemedicine visits were largely used for continuity of care purposes with an existing provider-patient relationship.
These visits were most common among those who lived near a border (57.2 percent of out-of-state visits).
Visits were largely for primary care and mental health treatment (64.3 percent of out-of-state visits).
People in rural communities were more likely to receive out-of-state telemedicine care (33.8 percent vs 21 percent).
There was high out-of-state telemedicine use for cancer care (9.8 percent of all telemedicine visits for cancer care).