Because of this rule, the program requires clinics and pharmacies to be under the same roof — a setup that doesn’t exist in many regions, particularly in rural areas.
The federal map shows no sites in Wyoming or South Dakota other than military clinics, which don’t serve the public. People in dozens of other regions would have to drive more than 100 miles to reach the nearest clinic, according to a KHN review of participating locations.
The Wyoming Department of Health is working to enroll providers in the program, spokesperson Kim Deti said.
Montana has four public-facing test-to-treat clinics, according to the federal website and Jon Ebelt, a spokesperson for Montana’s Department of Public Health and Human Services. He said that seven Defense Department and Indian Health Service facilities also provide test-to-treat services, but those aren’t open to most people.
Billings, the state’s most populous city, is more than a three-hour drive from the nearest site shown on the map. Ebelt said the agency is working with a local primary-care nonprofit to find more facilities to enroll.
We have to get this right, said Bibbins-Domingo, the San Francisco professor. She said that as the U.S. moves away from restrictions like mask mandates, the public health system must ensure that everyone can get these new treatments, which can get people back to work sooner, prevent serious illnesses, and even save lives.
For those far from clinics, people with disabilities, and people too sick to leave home, telehealth could be the easiest way to get treated. A few local governments, including Los Angeles County and New York City, have launched virtual care initiatives.
Truepill, a company that provides telehealth and pharmacy technology, offers online covid assessments through its website findcovidcare.com for a fraction of the cost of CVS’ in-person or telehealth operations. The company has filled more than 10 million prescriptions in the past five years.
The service, available in all 50 states and Washington, D.C., costs $25 to $55. Though insurance isn’t accepted, the cost is comparable to insurance copays for in-person doctor appointments. Prescriptions can be sent to a local pharmacy for no additional charge or shipped to a home overnight via FedEx for a $20 fee.
HHS didn't respond to requests for data on antiviral use and has repeatedly declined to allow KHN to observe weekly virtual meetings about the program held with state health officials, clinic directors, and other health care providers.
Bibbins-Domingo said that to be effective, the federal government must make it easier to get testing and treatment, especially when the program is geared toward those at highest risk of devastating complications from Covid.
“If you're just an average person trying to navigate this,” she said, “it’s actually completely impossible.”
KHN correspondents Katheryn Houghton and Rachana Pradhan contributed to this report.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.