Massachusetts received a ‘B’ grade for telehealth access in 2025, according to a new report from the Cicero Institute and Pioneer Institute. The report breaks down state trends in telehealth policies, ranking Massachusetts above most states but noting there is still room for improvement.
“Telehealth is one of the most efficient and cost-effective tools we have to expand access to care, especially in rural and underserved communities,” said report author Josh Archambault. “But most states are still clinging to outdated laws that limit competition, raise costs, and prevent patients from benefiting fully from modern care delivery.”
The State Policy Agenda for Telehealth Innovation, conducted by the Pioneer Institute and Cicero Institute and released Monday, advocates for legislation broadly expanding telehealth access across the U.S., with a particular focus on improving rural healthcare.
The report grades states based on four key metrics:
– Whether they are “modality neutral,” meaning policies allow patients to use a range of telehealth options rather than just a single mode such as live video.
– Whether patients can “start telehealth in any mode” based on their own needs and preferences.
– Whether the state creates “no barriers for patients to access across-state-line telehealth.”
– Whether nurses are allowed “independent practice” without doctor oversight.
Nine states earned an “A” or “A+” rating, with the highest grades awarded to Arizona, Colorado, Delaware, and Utah. Conversely, ten states—including Tennessee, South Carolina, North Carolina, and Virginia—received an “F.”
Massachusetts ranked in the middle tier with a “B” grade. The score reflects “continued barriers to across-state-line telehealth access and limits on provider flexibility, even as the state performs better than many peers,” the report states.
In addition to advocating for expanded access across state lines, the report recommends that Massachusetts remove the requirement for nurses to have two years of experience before being allowed to prescribe medications.
The report also highlights a 2025 trend of introducing numerous bills aimed at establishing multistate compacts for individual professions, including dentistry, nutrition, and especially social work. While this piecemeal approach acknowledges the need for greater interstate telehealth access, the report argues it “falls far short of other reform solutions that could remove barriers to access across the board.”
Instead, the report promotes a “registration bill” approach, which would allow patients broader access to out-of-state providers in a more streamlined manner.
Notably, only the four states with the highest overall ratings—Arizona, Colorado, Delaware, and Utah—earned top marks for their out-of-state telehealth policies.
The report also references the federal government’s new five-year Rural Health Transformation Program, which allocates $50 million in funding to states. Approximately 30% of the points tied to policy-related funding “can be directly or indirectly connected to telehealth, depending on how aggressively a state integrates telehealth into its initiatives and regulatory agenda,” the release explains.
Overall, the report underscores the importance of modernizing telehealth policies nationwide to expand access, reduce costs, and improve patient outcomes—particularly for rural and underserved communities.
https://www.bostonherald.com/2026/01/12/report-grades-massachusetts-telehealth-policies-a-b/