Uneven Access: How Rurality and State Policies Shaped Telehealth Provision to Medicaid Enrollees, 2020-2021

Authors

• Mandar Bodas, Department of Health Policy and Management, Fitzhugh Mullan Institute for Health Workforce Equity, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
• Yoon Hong Park, Department of Health Policy and Management, Fitzhugh Mullan Institute for Health Workforce Equity, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
• Qian Luo, Department of Health Policy and Management, Fitzhugh Mullan Institute for Health Workforce Equity, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
• Anushree Vichare, Department of Health Policy and Management, Fitzhugh Mullan Institute for Health Workforce Equity, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.

Document Type

Journal Article

Publication Date

4-1-2026

Journal

Telemedicine journal and e-health : the official journal of the American Telemedicine Association

Volume

32

Issue

4

DOI

10.1177/15305627251412737

Keywords

Medicaid; health workforce; prenatal care; telehealth; telehealth payment policies

Abstract

OBJECTIVE: This study assesses how providers delivered telehealth services to pregnant Medicaid enrollees, using multistate Medicaid claims data. It also examines how provider rurality and state-level telehealth policies influenced provision. METHODS: We analyzed claims data on telehealth provision from the Transformed Medicaid Statistical Information System Technical Analytic File from January 2020 to April 2021. Monthly telehealth provision was estimated for family physicians, obstetricians and gynecologists, nurse practitioners, and physician associates, and variations therein were examined by rurality and state policy. RESULTS: Telehealth provision peaked in April 2020, when 19.5% of providers delivered at least one telehealth service. At the peak in April 2020, rural providers were less likely to provide telehealth than urban providers (15.2% vs. 20.6%), and states with telehealth-supportive policies saw higher provision of telehealth by providers (20.9%) than those without (14.3%). Throughout the study period, rural providers from all specialties in nonsupportive policy states showed the lowest telehealth provision. CONCLUSIONS: Provider location rurality and state policy environments significantly influenced telehealth provision. Sustained policy support is essential to ensure equitable access to perinatal care.

APA Citation

Bodas, Mandar; Park, Yoon Hong; Luo, Qian; and Vichare, Anushree, "Uneven Access: How Rurality and State Policies Shaped Telehealth Provision to Medicaid Enrollees, 2020-2021" (2026). GW Authored Works. Paper 9166.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/9166

Department

Health Policy and Management