When they need surgery, nearly one in three Americans may find themselves in a precarious position: They live more than an hour’s drive from a high-quality hospital, and their insurance plan may leave them paying more than they can afford out of their own pockets. The situation is worse for Americans living in rural areas.

New research suggests that people who live in rural areas may be benefiting from telehealth as a modality for substance use disorder treatment to a greater extent than their urban counterparts. Meanwhile, despite accounting for the vast majority of substance use disorder services, people covered by Medicaid managed care are less likely to use telehealth compared with their counterparts who have Medicare Advantage or are commercially insured.