There's no question it can make a meaningful difference near-term. The obvious long-term solution is further urbanization or near-urbanization, convincing people to leave those dying regions for greater opportunity.
Also, this idea: https://news.ycombinator.com/item?id=15136091
When I call a support line and get "Walter" who is going to help me, I know they are in a different hemisphere and am mostly unsatisfied with talking to them because they are trained with scripts and they talk like robots.
If I called and recognized a Kentucky accent, chances are that person is going to be more relatable and personable than "Walter" from 8 timezones away.
Mr./Mrs. Kentucky might crack a joke and get me to lighten up a little about why XYZ isn't working. If both calls have the same result, I walk away from talking to Mr./Mrs. a little more satisfied than with "Walter".
The same could be said if it was reversed, if someone was calling from the far east and ended up talking with Mr./Mrs. Kentucky it is going to be hard for them to be relatable and personable to someone from the far east.
Call centers insist so much on following scripts that I am not sure there would be opportunities to make jokes even if the person was in the same country as you.
Also, do you think that Americans want to hear a Kentucky accent? I would rather speak to a foreigner than hear someone with a village accent from my country. Those places have a reputation for low education and low culture, and so it is hard for customers to trust any employee with that accent who claims he can help you. I know that call centers have moved to my country and to the Philippines because English speakers in these countries have a more "neutral" accent.
I'd list all the telecommuting job sites, but there seems to be a thousand of them now.
The US median income is about $37,000 per year ($17-$18 per hour). To get beyond ~$13 to ~$17 per hour doing lower skill telecommuting work, you have to have a resume with something meaningful on it.
If you're from Appalachia, it's not difficult to teach yourself any number of skills (from database admin to javascript), go to a local small college to pad your resume with that, get a certification or two if applicable, and then get a job working remote at an entry level tech job that pays considerably better than anything local (few of those jobs exist locally there). A person can go work at a local AT&T or similar store doing sales in an Appalachian town, get some sales experience, and then go apply for a remote sales job making more than they'll get locally. Particularly right now is an ideal time, the US labor market is getting very tight.
I grew up in Appalachia and entirely self-taught my way out of it in the mid 1990s. It was a helluva lot more difficult to do back then. And that process is trivial compared to working in a coal mine, and it's a lot less soul destroying than toiling away for a decade earning $10-$15 at a local Walmart.