People are still searching out based upon geography. I've had a few people stray from geographic distant areas outside my knowledge base of local resource referral options. Had they not been on the more complex side I would have been willing to take them on after initial consult, but because of care needs I pointed them to their local areas should they have have issues.
In summary, I and patients aren't warming up to the theoretical expanded geography. And yes costs still will be the same, as leases don't go away, offices don't go away, as some care must still be in person, and support staff is still needed - fixed costs are still unchanged overall.