Does Telehealth Reduce Rural-Urban Care Access Disparities? Evidence from Covid-19 Telehealth Expansion

Abstract

Using hospital claims data, we study the effect of telehealth expansion on the disparities between care access in rural and urban areas during Covid-19. We use urban areas as the control group and compare the changes in patients' access to care before and after the telehealth expansion. We find that the rural-urban disparities in overall access to care (i.e., the total number of visits) remain unchanged after the policy. We further distinguish in-person from telehealth visits and find enlarged disparities in patients' visiting modalities. In particular, urban patients substitute in-person visits with telehealth visits, yet rural patients have a much lower adoption rate of telehealth services and continue with in-person visits. Finally, we perform visit-level analyses and identify patients' social determinants and physicians' characteristics associated with telehealth adoptions.