State Policies May Prevent Cancer Patients From Using Telehealth

State policies may prevent cancer patients from using telehealth, according to a study published in JNCI Cancer Spectrum.

Researchers found that, among cancer patients with private insurance, those living in states that did not provide coverage parity or payment parity were less likely to use telehealth in the first year of the COVID-19 pandemic.

The study included 53,982 patients who were diagnosed with breast cancer (33.3%), prostate cancer (28.9%), lung cancer (16.8%), colorectal cancer (12.3%), or lymphoma (8.7%) between March 2020 and March 2021.

Most of these patients (76.1%) had Medicare Advantage. Among patients who had private insurance, 11.0% lived in a state with telehealth coverage and payment parity, 7.4% lived in a state with coverage parity only, and 5.4% lived in a state with no or unspecified telehealth parity laws.

Most patients (70.6%) lived in states that allowed cross-state telehealth, but 29.4% lived in states with policies limiting cross-state telehealth.

In a multivariable analysis, several factors were associated with lower odds of using telehealth, including:

• Having private insurance and living in a state with coverage parity alone (vs both coverage and payment parity; odds ratio [OR], 0.82; 95% CI, 0.74-0.92; P =.001)
• Having private insurance and living in a state with no or unspecified telehealth parity laws (OR, 0.77; 95% CI, 0.70-0.85; P <.001)
• Having Medicare Advantage (OR, 0.59; 95% CI, 0.54-0.65; P <.001)
• Living in a state with limitations on cross-state telehealth (OR, 0.80; 95% CI, 0.76-0.85; P <.001)
• Having colorectal cancer (vs breast cancer; OR, 0.90; 95% CI, 0.84-0.97; P =.007)
• Being non-Hispanic Black (vs non-Hispanic White; OR, 0.83; 95% CI, 0.76-0.91; P <.001)
• Being 50-64 years of age (OR, 0.70; 95% CI, 0.64-0.77; P <.001), 65-74 years of age (OR, 0.67; 95% CI, 0.60-0.74; P <.001), or 75 years of age or older (OR, 0.61; 95% CI, 0.55-0.69; P <.001).

Patients diagnosed with cancer from May 2020 through March 2021 also had lower odds of using telehealth than patients diagnosed in March 2020 (P =.032 for May 2020; P <.001 for all other months).

The researchers noted that, despite having telehealth coverage, patients with Medicare Advantage were less likely to use telehealth than patients with private insurance. The researchers speculated that this could be related to patient or provider preferences, complexity of care, digital literacy or comfort with technology, access to digital technology, or reliable internet access.

When the researchers looked only at patients who were younger than 65 years of age and had private insurance, the results were similar to those seen in the overall population.

“Telehealth use by patients diagnosed with cancer during the pandemic was higher among those living in states with more generous parity and less restrictive rules for cross-state practice,” the researchers concluded. “Policy makers contemplating whether to permanently relax certain telehealth policies must consider the impact on vulnerable patient populations who can benefit from telehealth.”

This article originally appeared on Cancer Therapy Advisor