Telehealth Policy & Research: Closing Care Gaps – Bidisha Mandal, PhD

The increasing reliance on telehealth, particularly among food-insecure individuals, presents both opportunities and challenges for equitable healthcare access in the United States. Recent research from Washington State University, published in the American Journal of Managed Care in January 2026, highlights a notable trend: those facing food insecurity are more likely to utilize telehealth services, but also experience reduced overall healthcare visits. This suggests a complex interplay between access barriers, financial constraints, and the evolving landscape of healthcare delivery.

Food Insecurity and Healthcare Utilization

The study, led by Bidisha Mandal, PhD, analyzed data from the 2020-2022 Medical Expenditure Panel Survey to examine the relationship between food insecurity, access to a usual source of care, and telehealth utilization. Researchers found that food-insecure individuals had a 7.2% lower rate of annual healthcare visits – encompassing both in-person and telehealth appointments – compared to their food-secure counterparts. However, within that lower overall rate, a significant 1.7-percentage point increase was observed in the proportion of visits conducted via telehealth. The full study details these findings, employing logistic regression, Poisson models, and 2-stage Heckman selection models to account for various confounding factors.

This trend appears to be particularly pronounced for individuals with longer travel times to healthcare facilities. The study revealed that food insecurity was associated with a 2.6 percentage point higher share of telehealth visits for those with travel times of 15 to 30 minutes, and a 4 percentage point increase for travel times exceeding 30 minutes. This suggests that telehealth may be serving as a crucial bridge for those facing geographical barriers to care.

The Cost Factor: Telehealth and Expenditure Reduction

Beyond access, the research also uncovered a potential economic benefit associated with increased telehealth utilization. Each 1-percentage point increase in the share of telehealth visits corresponded to a $117.64 reduction in healthcare expenditures per visit. This finding, while preliminary, suggests that telehealth could contribute to cost savings within the healthcare system, potentially offsetting some of the financial burdens faced by vulnerable populations. AJMC’s coverage of the study emphasizes this cost-lowering effect.

Understanding the Limitations and Nuances

It’s important to note that this study establishes an association, not necessarily causation. While the data strongly suggest a link between food insecurity and telehealth utilization, it doesn’t definitively prove that food insecurity causes individuals to choose telehealth. Other factors, such as digital literacy, access to reliable internet, and comfort with technology, likely play a role. The study also relies on self-reported data regarding food security, which may be subject to recall bias or social desirability bias.

the study focuses on office-based and outpatient visits, specifically general checkups, diagnosis/treatment, psychotherapy, and follow-up care. It does not encompass emergency room visits or hospitalizations, which may represent a different pattern of healthcare utilization among food-insecure individuals. The timeframe of the study (2020-2022) also coincides with the COVID-19 pandemic, which significantly accelerated the adoption of telehealth across all populations. It remains to be seen whether these trends will persist as the pandemic recedes.

Telehealth in a Broader Context: Cancer Care and Beyond

The increased adoption of telehealth isn’t limited to primary care or addressing food insecurity. Remote care models are gaining traction in specialized fields like oncology. Recent reports highlight the importance of addressing gaps in digital health and telehealth specifically for cancer patients, particularly in light of lessons learned during the pandemic. This underscores a broader shift towards leveraging technology to improve access and outcomes across a range of healthcare needs.

What This Means for Patients

For individuals experiencing food insecurity, telehealth can offer a more accessible and affordable way to connect with healthcare providers. It can reduce transportation costs, minimize time away from work, and overcome geographical barriers. However, it’s crucial to recognize that telehealth is not a panacea. It may not be suitable for all medical conditions, and it requires access to reliable technology and internet connectivity, which can be a challenge for some vulnerable populations.

It’s also important to maintain a usual source of care, even when utilizing telehealth services. Having a consistent healthcare provider allows for continuity of care and facilitates more comprehensive health management. Individuals should discuss their food security status with their healthcare providers, as this information can help inform personalized care plans and connect them with relevant resources.

Policy Implications and Future Research

The findings from Dr. Mandal’s research have significant implications for healthcare policy. The study suggests that integrating food insecurity screening into healthcare settings could help identify individuals who may benefit from telehealth services. Developing hybrid telehealth models, such as mobile clinics equipped with telehealth capabilities, could further expand access to care for food-insecure populations.

Further research is needed to explore the long-term impact of telehealth on health outcomes among food-insecure individuals. Studies should investigate the effectiveness of different telehealth interventions, assess the impact of digital literacy and access on telehealth utilization, and examine the cost-effectiveness of telehealth compared to traditional in-person care. Research should focus on identifying and addressing the barriers to telehealth access for vulnerable populations, such as language barriers, cultural differences, and lack of technical support.

Looking Ahead: Addressing Systemic Disparities

addressing the disparities in healthcare utilization highlighted by this research requires a multi-faceted approach. This includes not only expanding access to telehealth but also addressing the root causes of food insecurity through policies that promote economic stability, affordable housing, and access to nutritious food. Continued monitoring of telehealth trends and ongoing research will be essential to ensure that these technologies are used equitably and effectively to improve the health and well-being of all individuals.