19 pandemic, widespread use of telehealth by safety net organizations prevented the extreme decline in total visits that other health care organizations experienced. FQHCs in California, for example, were able to use audio-only (telephone) visits to sustain service provision at pre-pandemic levels (after a dip during initial shutdown precautions) for both primary care and behavioral health care. Furthermore, unpublished research by Uscher-Pines, Sousa, et al., 2020, showed that by offering hybrid care models that incorporated telephone, video, and in-person visits, FQHCs were able to reduce their noshow rates and decrease their wait times, in comparison with pre-pandemic levels. It is important to note, however, that although telehealth can increase access across populations, there is a risk that its introduction can inadvertently increase disparities without careful consideration to the digital divide and patient preferences. Certain patient populations might be left behind when telehealth is implemented, including individuals without access to broadband, those who are not proficient in English, and those with limited digital literacy. Telehealth can overcome some of the longstanding access barriers that lowincome patients have faced. 8 Although the California FQHCs did not find that the transition to telehealth led to disparities in the utilization of telehealth services among safety net patients, this is not always the case, especially when access is expanded broadly rather than in a targeted manner. A different study of telehealth uptake during the pandemic found that telehealth’s reach into communities with lower incomes and communities of color was limited (Whaley et al., 2020). Despite the marked increase in telehealth visits in March and April 2020, telehealth uptake in lower-income neighborhoods was one-third as large as in wealthier neighborhoods. Substance Use Disorder Prior to the COVID-19 pandemic, SUDs were among the few conditions that could be treated via telehealth in Medicare without originating-site and geographic restrictions. The SUPPORT Act of 2018 allowed Medicare beneficiaries to be treated for SUD in their homes (Pub. L. 115-271). Yet other barriers still limited telehealth’s use: The Ryan Haight Act of 2008 (Pub. L. 110-425), for example, specifically prohibited the prescribing of controlled substances used for the treatment of opioid use disorder (OUD) via telehealth without at least one in-person visit. It appears that the SUPPORT Act alone was not enough to drive adoption of telehealth by licensed addiction treatment facilities. In 2019, only 17 percent of these facilities had telehealth capacity (Uscher-Pines et al., 2020). Several recent trends have contributed to the growth of tele-OUD services, however. During the pandemic, the Ryan Haight requirement for an in-person visit prior to medication treatment initiation via telehealth was waived. This change allows providers to treat new patients located outside their immediate communities and to offer additional convenience to patients. Furthermore, multiple telehealth companies that operate independently of traditional brick-and-mortar clinics have emerged in the past three years to treat OUD at home. Even after the public health emergency is lifted, there likely will be a pathway for telehealth clinicians to register with the DEA to sidestep the Ryan Haight requirement because of the SUPPORT Act (Dunham and Sprankle, 2018). Telehealth for OUD shows real promise, especially in rural communities: More than half of all rural communities in the United States have no providers who can prescribe medications for OUD. If telehealth can reach patients struggling with OUD who might not otherwise have sought care by developing strong connections with providers from the comfort of their own home, it could be a powerful tool to combat the opioid epidemic, which predates and will surely outlast the COVID-19 pandemic (Uscher-Pines, Huskamp, and Mehrotra, 2020). Telehealth for OUD care could help boost utilization of underused services and improve treatment retention by making visits more convenient and less prone to stigma. Patients seeking care for OUD often need to spend substantial amounts of time and money traveling to and attending clinic visits, and the intensity of treatment can be incompatible with work and caregiving responsibilities. Telehealth can minimize these negative effects on patients. Increasing access to telehealth for patients with OUD should be prioritized because many patients do not receive enough care, treatment of OUD is lifesaving, and telehealth can reduce barriers to care that result in poor adherence and retention. 9 Chronic Conditions Telehealth could be particularly useful for patients whose care requires many ongoing interactions with clinicians. One study found that families needing to consult pediatric subspecialists for their children’s health care might be especially interested in how telemedicine can complement, rather than replace, in-person visits (Ray et al., 2017). Researchers spoke with parents and caregivers of children needing specialty pediatric care, looking for their thoughts on how best to implement telemedicine for patients and families. To their surprise, families were less interested in full telemedicine visits than in supportive care coordination activities—such as pre- or post-visit triage or follow-up