Study: Limiting out-of-state telehealth could disrupt existing patient-provider relationships

JAMA Health Forum revealed a cross-sectional examine suggesting reimplementing that licensure restrictions on out-of-state telemedicine, which had been lifted as a result of COVID-19 pandemic, would have probably the most vital impact on sufferers dwelling close to a state border, these in rural areas, and people receiving major care or psychological well being remedy.

“Relaxation of state restrictions would likely offer immediate convenience to patients who live near a state border and those receiving primary care and mental health treatment,” the examine’s authors wrote. “These patients are subject to an accident of geography; two patients receiving the same care may have very different experiences. A patient with a primary care physician who lives in the middle of a state can access care via telemedicine. However, a similar patient living near a state border with a primary care physician in the neighboring state now will have to physically travel to that appointment.”


When COVID-19 emerged, many states briefly allowed physicians to offer care in states during which they didn’t maintain a license, thus permitting for the elevated availability of suppliers to these in areas with fewer medical amenities and assets.

Researchers aimed to find out which sufferers and specialties had been utilizing out-of-state telemedicine visits amongst Medicare beneficiaries throughout COVID-19. They analyzed 100% Medicare fee-for-service (FFS) claims from January via June 2021.

This interval was chosen as a result of it was after the impression of the early pandemic, when vaccines had been obtainable and the healthcare system stabilized however earlier than momentary licensing laws started to lapse.

Researchers famous that within the first half of 2021, 8,392,092 sufferers had been seen by a supplier through telemedicine, 5% of which had a number of telemedicine visits with an out-of-state supplier.

Patients dwelling in a county near a state border accounted for 57.2% of all out-of-state telemedicine visits, and 64.3% of these out-of-state visits had been with a major care or psychological well being clinician. In 62.6% of all out-of-state visits, prior in-person visits occurred between the identical affected person and healthcare supplier.

Compared with sufferers who solely had in-state telehealth appointments, these accessing out-of-state care had been extra prone to be dual-eligible for Medicaid and dwell in rural areas.

Researchers be aware there are limitations to their evaluation, together with its concentrated concentrate on the Medicare inhabitants, and its analysis primarily based on the affected person’s dwelling handle and the clinician’s observe handle, which could be inaccurate. They additionally centered on sufferers who had in-state and out-of-state telemedicine visits, not ones who had telemedicine visits typically.


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