(22) Recovery is WORTH IT: Data from a Statewide Low-Threshold Buprenorphine Telehealth Program

Background & Introduction: Opioid-related mortality in Wisconsin has increased significantly in the past decade (Wisconsin DHS, 2025). Buprenorphine is an evidence-based treatment for OUD; however, access remains limited for many underserved populations (Morenz et al., 2025). Traditional OUD treatment models frequently impose high-threshold requirements, including mandatory counseling, rigid toxicology schedules, in-person visits despite transportation barriers, abstinence requirements, insurance prerequisites, and prolonged wait times for an intake (Jakubowski et al., 2020). As a result, there is a substantial unmet need for OUD treatment. Data have demonstrated that telehealth-based buprenorphine treatment is associated with higher odds of treatment retention compared to in-person-only care (Hammerslag et al., 2023). We have designed and launched WORTH IT (Wisconsin Opioid Recovery Telehealth Immediate Treatment), a statewide low-threshold buprenorphine program aimed at reducing structural barriers and expanding equitable access to MOUD.

Methods: We conducted a retrospective program evaluation of patients (n = 142) enrolled in WORTH IT between program inception (July 2025) and the most recent month for which data are available (December 2025). As a low-threshold program, we offer same- or next-day telehealth intakes and immediate buprenorphine prescribing without requirements for initial toxicology testing, mandatory psychosocial services, or insurance coverage. Our approach is rooted in harm reduction, prioritizing access to life-saving medication and patient safety. Using EHR-derived data analyzed with Power BI, we examined descriptive program metrics related to reach, patient engagement, and treatment retention to characterize early program performance.

Results: During the six-month evaluation period, the WORTH IT program completed 142 intakes across 31 counties and one tribal nation. Treatment engagement was high: 88% of patients were prescribed MOUD, and 85% returned for a second session. By the second appointment, 83% had started their prescribed MOUD. Longitudinal retention was robust with 43% of the patients completing six or more sessions. In total, the program facilitated 994 distinct clinical appointments, including 594 prescriber, 261 therapy, and 139 case management sessions. The program successfully reached populations disproportionately affected by structural barriers to care: 73% of the patients treated were justice-involved individuals, and 22% identified as racially or ethnically minoritized. Regarding socioeconomic barriers, the program treated 16 uninsured patients and fully funded 42 buprenorphine prescriptions for individuals without medication coverage or an ability to pay.

Conclusion & Discussion: Statewide low-threshold buprenorphine treatment delivered via telehealth is a viable strategy for expanding access to MOUD. By leveraging telehealth, we have engaged an underserved population historically marginalized by high-threshold treatment models. In addition to offering low-threshold MOUD, our program integrates optional therapy and case management, empowering patients to determine the level of additional recovery services they wish to receive. Our findings show high uptake of therapy and case management, suggesting that a low-threshold telehealth entry point may enhance downstream utilization of integrated behavioral health and social support services. Our program can serve as a model for other states looking to scale MOUD access rapidly and equitably.

References: Wisconsin Department of Health Services. Opioids: Data Summary Dashboard. Updated October 27, 2025. Accessed January 13, 2026. https://www.dhs.wisconsin.gov/opioids/dashboards.htm

Morenz AM, et al. Barriers to accessing medications for opioid use disorder among rural individuals. Int J Drug Policy. 2025;140:104321. doi:10.1016/j.drugpo.2024.104321

Jakubowski, A., & Fox, A. (2020). Defining Low-threshold Buprenorphine Treatment. Journal of addiction medicine, 14(2), 95–98. https://doi.org/10.1097/ADM.0000000000000555

Hammerslag LR, Mack A, Chandler RK, et al. Telemedicine Buprenorphine Initiation and Retention in Opioid Use Disorder Treatment for Medicaid Enrollees. JAMA Netw Open. 2023;6(10):e2336914. doi:10.1001/jamanetworkopen.2023.36914