Rural-urban disparities in chemotherapy administration and quality certifications in Minnesota.

e13563 Background: Rural cancer patients experience disparities in access and outcomes compared to their urban counterparts. Quality certifications like ASCO's Quality Oncology Practice Initiative (QOPI) and the American College of Surgeons' Commission on Cancer (CoC) accreditation aim to standardize high-quality care. We examined rural-urban differences in chemotherapy administration sites and certifications in Minnesota. Methods: Using the Minnesota All-Payer Claims Database (2022), we identified billing providers with claims for carboplatin and paclitaxel (CPT: J9045, J9264, J9267). Providers were geolocated and assigned Rural-Urban Commuting Area (RUCA) codes, categorized as urban (RUCA 1-3) or rural (RUCA 4-10). QOPI certification status was obtained from ASCO, and CoC accreditation from ACS. Results: Among 104 providers, 55 (53%) were rural, accounting for 10,117 (27%) of 37,526 claim lines. No rural providers (0%) were QOPI-certified, compared to 16% in urban areas. Rural providers had lower CoC accreditation rates (26% vs 43% in urban areas). Conclusions: Rural Minnesota providers comprise over half of chemotherapy sites but deliver a minority of treatments and lack QOPI certification. Expanding QOPI and CoC programs in rural areas represents a key opportunity to improve equitable, high-quality cancer care delivery across America.