Telehealth among US hospitals: several factors, including state reimbursement and licensure policies, influence adoption

Health Aff (Millwood). 2014 Feb;33(2):207-15. doi: 10.1377/hlthaff.2013.1054.


Telehealth is widely believed to hold great potential to improve access to, and increase the value of, health care. Gaining a better understanding of why some hospitals adopt telehealth technologies while others do not is critically important. We examined factors associated with telehealth adoption among US hospitals. Data from the Information Technology Supplement to the American Hospital Association's 2012 annual survey of acute care hospitals show that 42 percent of US hospitals have telehealth capabilities. Hospitals more likely to have telehealth capabilities are teaching hospitals, those equipped with additional advanced medical technology, those that are members of a larger system, and those that are nonprofit institutions. Rates of hospital telehealth adoption by state vary substantially and are associated with differences in state policy. Policies that promote private payer reimbursement for telehealth are associated with greater likelihood of telehealth adoption, while policies that require out-of-state providers to have a special license to provide telehealth services reduce the likelihood of adoption. Our findings suggest steps that policy makers can take to achieve greater adoption of telehealth by hospitals.

Keywords: Hospitals; Information Technology; Legal/Regulatory Issues; Organization and Delivery of Care; State/Local Issues.

Publication types

  • Review

MeSH terms

  • Delivery of Health Care / organization & administration*
  • Female
  • Health Care Reform*
  • Health Plan Implementation / organization & administration*
  • Health Policy
  • Hospitals
  • Humans
  • Licensure / legislation & jurisprudence
  • Male
  • Organizational Innovation
  • Outcome Assessment, Health Care*
  • Patient Protection and Affordable Care Act
  • Policy Making
  • Quality Improvement
  • Reimbursement Mechanisms
  • Telemedicine / organization & administration*
  • United States