Study Reveals Rural Cancer Patients Often Cross State Borders for Treatment, Highlighting the Role of Telehealth
A federally funded study led by researchers at Huntsman Cancer Institute, University of Utah, has shed light on the travel burdens faced by cancer patients—particularly those from rural areas. The findings, published in JAMA Network Open, show that around 7% of Medicare cancer patients seek treatment in another state, with rates nearly twice as high for those living in rural communities.
Dr. Tracy Onega, senior study author and senior director of population sciences at the Institute, emphasized the policy significance of these findings. “This highlights the urgent need to revisit telehealth regulations and licensure requirements across states,” she said. Onega also holds multiple academic roles at the University of Utah.
The study analyzed data from over 1 million Medicare beneficiaries with cancer. Among all patients, 8.3% traveled out of state for surgery, 6.7% for radiation therapy, and 5.6% for chemotherapy. For rural patients, the numbers were far higher:
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18.5% crossed state lines for surgery
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16.9% for radiation treatment
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16.3% for chemotherapy
While telemedicine has become a valuable tool since the COVID-19 pandemic, Dr. Onega points out that it cannot replace in-clinic treatments like surgery or radiation. However, telehealth can support the continuum of care through virtual surgical assessments, treatment monitoring, and managing side effects. “A remote consultation can help avoid unnecessary travel for post-surgical follow-ups or treatment evaluations,” she explained.
Telehealth services are particularly important for Huntsman Cancer Institute, which provides care across five predominantly rural Mountain West states—Utah, Idaho, Wyoming, Montana, and Nevada. In many cases, patients must travel long distances to access the specialized care they need.
Despite its potential, state-based licensure policies remain a major roadblock. While some states offer reciprocal licensing arrangements, many still adhere to outdated models that hinder interstate telehealth practice. “We need broader licensure flexibility to support patient care across state borders,” said Onega.
She added that more inclusive policies could lead to improved outcomes—not only for patients, but also for caregivers, providers, and insurers. “Our mission is to ensure that advancements in cancer treatment reach everyone, regardless of where they live. People should not be disadvantaged just because they live far from a cancer center.”
The study was supported by the National Institutes of Health/National Cancer Institute and the Huntsman Cancer Foundation, under grant P30 CA042014.
