Telehealth in Urologic Oncology: Temporal Trends and Patient Characteristics in the United States

To better characterize population-level data on utilization trends, patient-level predictors, and downstream costs of telehealth use across GU malignancies using a national commercial insurance claims database.

We extracted bladder, kidney, prostate, and testis cancer outpatient claims from the Merative MarketScan database. Telehealth claims were flagged from 2010 to 2023, and multivariable modeling was used to identify patient-level factors. Weighted generalized linear models were used to compare twelve-month insurer-paid and out-of-pocket spending after telehealth or in-person new patient visits. Two time-range cohorts were analyzed: pre-pandemic (2010-2019) and pandemic-era (2020-2022).

There were 85,237 telehealth visits, which represented 0.25% of GU oncology claims. Telehealth use reached 1.93% in 2020 and fell to 1.06% by 2023. Men (OR 1.4; P <.001), patients in the West (OR 1.6; P <.001), and those with non-PPO insurance (OR 1.2; P <.001) were more likely to use telehealth; non-urban patients (OR 0.68; P <.001) and those with higher comorbidity burden (OR 0.92; P <.001) were less likely. Prostate and kidney cancer had the highest telehealth rates; bladder cancer had the lowest. New patient oncology visits initiated via telehealth had lower patient out-of-pocket (OOP) spending in the pre-pandemic (SR 0.49; P = .011) and pandemic-era (SR 0.82; P = .0001) cohorts. Insurer-paid spending was comparable.

Telehealth use in urologic oncology varies by cancer type, location, and insurance. It may lower costs for patients, which warrants further investigation and policy investment.