Abstract C093: Disparities and trends in oncology telehealth utilization among medicare beneficiaries

Abstract Background: The COVID-19 pandemic catalyzed rapid expansion in telehealth services, yet concerns persist about equitable access, particularly in oncology care where vulnerable populations may face additional barriers. This study investigates demographic, clinical, and geographic predictors of telehealth utilization among Medicare beneficiaries newly diagnosed with cancer during the pandemic. Methods: We conducted a retrospective cohort analysis using CMS Medicare claims from 3/2020-12/2022, identifying 603,965 patients with incident diagnoses of prostate, breast, lung, colorectal, bladder, or gastric cancer. The primary outcome was having at least one oncology-related telehealth visit within one year of cancer diagnosis. Multivariable logistic regression estimated odds of telehealth utilization, adjusting for age, sex, race/ethnicity, cancer type, diagnosis year, and rural/urban designation, p0.01 was significant. Results: Overall, 33.7% (n=203,573) of patients had at least one oncology telehealth visit. Although Black and Hispanic patients had a lower odds of utilizing telehealth (OR: 0.85; 95% CI: 0.83-0.87, p0.01) and (OR: 0.93; 95% CI: 0.91-0.96 p0.01) of telehealth utilization compared to non-Hispanic White patients, telehealth utilization was actually high both in Blacks and Hispanic patients, 31.0% and 33.3% respectively (on par with Non-Hispanic White patients 34%). Rural patients had high/ preserved utilization of telehealth 33.7%, compared to 33.7% of patients living in urban populations. Cancer type strongly predicted utilization: patients with prostate (OR: 0.25; 95% CI: 0.25–0.26) and bladder cancers (OR: 0.22; 95% CI: 0.21–0.22) had markedly lower odds of utilizing telehealth, while those with gastric (OR: 1.290; 95% CI: 1.243–1.340) and lung cancers (OR: 1.132; 95% CI: 1.112–1.151) had higher odds compared to breast cancer patients. Telehealth utilization increased significantly from 2020 to 2022 and remained high at roughly 33.9% in the final year of the pandemic. Conclusions: While there are some race/ethnic disparities in utilization of telehealth, cancer type was the strongest predictor of telehealth utilization, potentially due to need for in-person visits/ procedures. Universally, all patients were high users of telehealth during the pandemic and interestingly this utilization remained high even towards the end of the pandemic, likely signifying a paradigm shift in cancer care delivery towards telehealth as a standard means of care. Further studies will be needed to provide equitable access to telehealth. Citation Format: Sakshith Reddy Chintala, James Murphy, Hala Madanat, Elena Martinez, Richard Cripps, Brett Meyer, Humberto Prada Jr., Juan Javier-Desloges. Disparities and trends in oncology telehealth utilization among medicare beneficiaries abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C093.