Rural Patients Traveling Across State Lines for Cancer Treatment

Recent research from the Huntsman Cancer Institute at the University of Utah reveals that a significant portion of Medicare patients, particularly those living in rural areas, are traveling across state lines to access cancer care. The study found that 7% of Medicare beneficiaries sought cancer treatment outside their home state, with this figure nearly doubling for rural patients.

According to Tracy Onega, a senior researcher and director of population sciences at the institute, the findings highlight critical implications for telehealth policies and physician licensure. Many cancer patients face long journeys to receive specialized care, and existing regulations can hamper the ability of healthcare providers to follow up with these patients through virtual means.

The study, published in JAMA Network Open, involved a survey of over 1 million Medicare recipients diagnosed with cancer. The data indicated that 8.3% of all cancer patients crossed state borders for surgical procedures, while 6.7% traveled for radiation therapy, and 5.6% for chemotherapy. Among rural patients, the numbers were even more pronounced: 18.5% traveled for surgery, 16.9% for radiation, and 16.3% for chemotherapy.

Onega emphasized that while telemedicine cannot replace essential clinical services that require in-person visits, it can effectively bridge the gaps in cancer treatment. For instance, while surgical evaluations must occur at a physical clinic, follow-up assessments can be conducted through telehealth, reducing the travel burden on patients and their families, especially in remote areas.

Telehealth services can also manage treatment side effects, facilitate clinical trial check-ins, and provide preventive care. The Huntsman Cancer Institute serves patients from five largely rural states: Idaho, Montana, Nevada, Utah, and Wyoming. Many patients travel significant distances for specialized cancer care, making telehealth an invaluable tool for enhancing access.

Since the onset of the COVID-19 pandemic, the use of telemedicine has surged. According to the National Center for Health Statistics, approximately 37% of adults over 18 utilized telehealth services in 2022. However, barriers remain due to varying state regulations governing medical licensure, which can restrict cross-state telehealth practices.

Some states have established reciprocity agreements allowing physicians licensed in one state to practice in neighboring states, but these arrangements are limited. Onega advocates for expanding these policies to eliminate barriers that prevent physicians from providing care via telehealth across state lines.

By reforming telehealth policies, there could be significant benefits for patients, caregivers, healthcare teams, and insurers. Improved access to care can lead to better patient outcomes, particularly for those living in rural areas who may not have immediate access to urban healthcare facilities.

As advancements in cancer care technologies continue to emerge, it is crucial to ensure that individuals in remote locations receive the same level of care as those in urban settings, promoting equity in healthcare access.