Telehealth has reshaped how hospitals deliver care across America. Yet, not every state has embraced this shift equally. A new analysis by Definitive Healthcare — using proprietary hospital data — reveals striking differences in how widely hospitals across all 50 states and Washington D.C. have adopted telehealth services. The findings offer healthcare leaders a clear look at where virtual care is thriving and where significant gaps remain.
Why Telehealth Adoption Varies Across States
Several factors drive the uneven spread of hospital telehealth. Rural geography, state-level regulations, broadband infrastructure, and reimbursement policies all shape how quickly hospitals bring telehealth to patients. Moreover, states with stronger Medicaid telehealth coverage policies often see higher adoption rates overall.
Importantly, the COVID-19 pandemic accelerated adoption everywhere. However, the data shows that momentum varied by region. Midwestern and Northeastern states, in particular, surged ahead — while Southern and island states fell well behind the national pace.
Top 10 States Leading in Hospital Telehealth
Minnesota Tops the Nation at 80.8%
Minnesota leads all states, with 80.8% of its hospitals offering telehealth services. Close behind, Michigan reaches 80.3% and Wisconsin follows at 80.2%. These three Midwestern states form a clear top tier in virtual care delivery.
Furthermore, South Dakota posts an impressive 79.2%, and North Carolina — the only Southern state in the top five — reaches 78.7%. Iowa (78%), Vermont (76.5%), Pennsylvania (76.4%), and Oregon (76.1%) round out the top nine. Indiana closes the top 10 at 73.5%.
Together, these leading states demonstrate that strong rural outreach needs, robust health system networks, and favorable state policy support all fuel higher telehealth uptake.
The Middle of the Pack: States 11–30
A Broad Range from 55% to 73%
States ranked 11 through 30 show considerable variation. New York (73.1%) and Illinois (72.8%) lead this group, followed by Ohio at 71.9%. The District of Columbia comes in at 71.4%, and West Virginia reaches 71.1%.
Additionally, states like Virginia (69.7%), New Jersey (69%), Massachusetts (68.7%), and Missouri (68.7%) all cluster near the upper portion of this mid-range. Maryland (67.6%), Connecticut (67.3%), and Delaware (66.7%) maintain solid rates as well.
Toward the lower end of this band, Utah (64.3%), Montana (64.2%), Kentucky (63.8%), Nebraska (62.7%), Washington (57.5%), and Arizona (57.4%) still manage to cross the 55% threshold. North Dakota (57.1%) and South Carolina (55.8%) close out this group, with Rhode Island (55.6%) and California (55.1%) just ahead of them.
States Lagging Behind in Telehealth Adoption
Southern and Island States Struggle to Keep Up
Below 55%, adoption rates drop noticeably. Oklahoma and Maine both sit at 55%, while Tennessee reaches 52%. Alaska posts 51.7%, and both New Hampshire and Texas share 51.4%.
Beyond these, the numbers decline sharply. Idaho stands at exactly 50%, while Colorado (48.8%), Mississippi (48%), Florida (47.8%), Georgia (47.7%), Wyoming (47.2%), and Arkansas (47.1%) all fall below that halfway mark.
Alabama (46.5%), Nevada (45.1%), and Louisiana (43%) continue the downward trend. New Mexico (42.6%) and Kansas (40%) follow close behind. At the very bottom, Hawaii records the lowest rate in the nation — just 32.3% of its hospitals offer telehealth services.
The gap between Hawaii’s 32.3% and Minnesota’s 80.8% represents a nearly 50-percentage-point divide. Clearly, geography, connectivity, and policy alignment play decisive roles in where hospitals land on this scale.
What These Numbers Mean for Healthcare Leaders
Closing the Telehealth Gap Is a Strategic Priority
For health systems in lower-adoption states, this data highlights both a challenge and an opportunity. Patients in states with low telehealth penetration may face avoidable barriers to specialist access, chronic disease management, and behavioral health services.
Consequently, hospital executives in lagging states should evaluate where infrastructure investments, payer contract negotiations, and staff training could accelerate adoption. Federal support also matters — the recent House vote to reauthorize telehealth grants offers fresh momentum for systems that are still building out virtual care capacity.
Meanwhile, top-performing states offer replicable models. Midwestern health systems have effectively combined rural access imperatives with scalable telehealth platforms. Therefore, peer-learning and regional collaborations remain valuable tools for accelerating progress.
Key Takeaways
- Minnesota leads all U.S. states with 80.8% of hospitals offering telehealth.
- Hawaii ranks last at 32.3%, reflecting connectivity and geographic barriers.
- Midwestern states dominate the top 10, reflecting strong rural care demand.
- Southern states cluster in the bottom half of the national rankings.
- A nearly 50-percentage-point gap separates the top and bottom states.
- Policy, infrastructure, and reimbursement remain the key drivers of adoption.
