Massachusetts received a ‘B’ for telehealth access in 2025 from a new report from the Cicero Institute and Pioneer Institute breaking down state trends in telehealth policies — ranking the state above most but with 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 “But most states are still clinging to outdated laws that limit competition, raise costs, and prevent patients from benefiting fully from modern care delivery.”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 across the U.S., highlighting rural access to healthcare.

The report grades states on four metrics: whether they’re “modality neutral,” meaning policies allow patients to use a range of telehealth options as opposed to just single modes like live video; allow patients to “start telehealth in any mode” based on their own needs and preferences; create “no barriers for patients to across-state-lines telehealth; and allow nurses “independent practice” without doctors oversight.

Nine states received an “A” or “A+” based on meeting the criteria, with the highest grades going to Arizona, Colorado, Delaware and Utah. Among the ten states who scored an “F” were Tennessee, South Carolina, North Carolina, and Virginia.

Massachusetts ranked among the middle tier with a “B” grade. The score reflected “continued barriers to across-state-line telehealth access and limits on provider flexibility, even as the state performs better than many peers,” the institutes stated.

Along with expanding access across state lines, the report advocates for Massachusetts to removed the requirement for nurses to have two years of experience before being allowed to prescribe.

The report noted a continued trend throughout 2025 “of introducing a myriad of bills to establish multistate compacts for individual professions, including dentistry, nutrition, and especially social work.”

“This piecemeal approach recognizes the need for greater interstate telehealth access but falls far short of other reform solutions that could remove barriers to access across the board,” the report argues, advocating for a “registration bill” approach allowing patients broader access to out-of-state providers.

Related Articles

Lawmakers renew push for Norwood hospital

Medical bills can be vexing and perplexing. Here’s important advice for patients

Judge orders HHS to restore funding for children’s health programs as lawsuit continues

House passes bill to extend health care subsidies in defiance of GOP leaders

Massachusetts deaths from flu rises to four children, with two Boston deaths under two years old

Only the four states with the highest rating, Arizona, Colorado, Delaware and Utah, earned the highest rating for their out-of-state telehealth policies, the report states.

The report also notes the federal government’s new five-year Rural Health Transformation Program, which distributes $50 million in funding to states. About 30% of points tied to policy-related funding, the release states, “can be directly or indirectly connected to telehealth, depending on how aggressively a state bakes telehealth into its initiatives and regulatory agenda.”

The federal rural health program drew attention late in 2025 as several states’ funding applications were withheld from public access.