Impact of state telehealth policies on telehealth use among patients with newly diagnosed cancer
Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée à la COVID-19
Background: Telehealth restrictions were relaxed under the COVID-19 public health emergency (PHE). We examined telehealth use before and during the pandemic among patients with newly diagnosed cancers and the association between state policies and telehealth use.
Methods: The study cohort was constructed from Optum’s de-identified Clinformatics®Data Mart and included patients with lymphoma, female breast, colorectal, prostate, and lung cancer diagnosed between 3/1/2019 and 3/31/2021. We performed an interrupted time series analysis to examine the trend of cancer-related telehealth use within one month of diagnosis relative to the timing of the COVID-19 PHE and multivariable logistic regressions to examine factors, specifically state parity laws and regulations on cross-state practice, associated with telehealth.
Results: Of 110,461 patients, the rate of telehealth use peaked at 33.4% in 4/2020, then decreased to 12-15% between 9/2020 and 3/2021. Among the 53,982 patients diagnosed since 3/2020, telehealth use was significantly lower for privately insured patients residing in states with coverage-only parity or no/unspecified parity than those in states with coverage and payment parity (adjusted rate: 20.2%, 19.1%, and 23.3%, respectively). The adjusted rate was lower for patients in states with cross-state telehealth policy limitations than those in states without restrictions (14.9% vs. 17.8%).
Conclusions: 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. Policy makers contemplating whether to permanently relax certain telehealth policies must consider the impact on vulnerable patient populations who can benefit from telehealth.
JNCI Cancer Spectrum , résumé, 2022