Mississippi’s rural care realities are not abstract policy problems. They show up when a child misses a specialist follow-up because the drive is too long, when a rural clinic cannot stretch staff across rising demand, or when a hospital is asked to improve outcomes with limited physical reach. That is why understanding the pillars of the RHTP funding in the state of Mississippi and the benefits of the Dr. Miltie N9+ matters for healthcare leaders making capital, care model, and access decisions.

For organizations across Mississippi, Rural Health Transformation Program priorities tend to center on a few practical goals: expand access, strengthen care coordination, improve quality, support sustainability, and bring more care closer to where patients live. Those priorities are not separate from telehealth and connected care. In many cases, they depend on them.

The pillars of the RHTP funding in the state of Mississippi

While individual program requirements, grant cycles, and state-level implementation details can vary, the core pillars of rural health transformation are usually consistent. Mississippi providers evaluating technology investments should look at RHTP alignment through an operational lens rather than treating funding as a standalone budget event.

Access expansion is the first pillar

In Mississippi, access is often shaped by geography, transportation barriers, workforce shortages, and the uneven distribution of specialty services. Rural health clinics, critical access hospitals, community health centers, and pediatric-serving organizations need ways to reach patients outside the traditional exam room without sacrificing clinical usefulness.

This is where basic video visits are often not enough. Access expansion has more value when clinicians can perform guided virtual physical exams, review clinically relevant patient data, and support follow-up in schools, community sites, pediatric settings, and homes. Funding priorities tied to access generally favor solutions that do more than add another communication channel. They support care delivery capacity.

Care coordination is a second pillar

Rural transformation is rarely about one visit type. It is about continuity across settings, clinicians, caregivers, and time. Mississippi providers serving children, patients with chronic conditions, and underserved populations need systems that connect the exam, the care plan, the caregiver, and the next intervention.

Care coordination becomes especially important in pediatric care, including for autistic children and patients with special healthcare needs. These patients often benefit when clinical interactions happen in lower-stress environments and when caregivers can participate more directly. A technology model that supports a broader circle of care can help reduce missed follow-up, improve information flow, and keep care plans moving.

Quality and outcomes are a third pillar

Funding tied to rural transformation usually expects measurable improvement. That may include better chronic disease management, stronger preventive care performance, reduced unnecessary transfers, faster follow-up, and improved patient engagement. The common thread is that technology should support clinical decision-making, not sit on the edge of workflow.

For that reason, healthcare leaders should be cautious about tools that look innovative but do not produce usable data or fit routine care operations. If a virtual care platform cannot help providers capture meaningful findings, monitor patients consistently, and support action between in-person visits, its value in an outcomes-driven environment is limited.

Financial sustainability is the fourth pillar

Mississippi organizations cannot treat rural innovation as a pilot that never matures. RHTP-aligned investments need a path to operational sustainability, which often means reimbursement awareness, workforce efficiency, and service-line flexibility.

That is where many digital health initiatives struggle. They may solve a narrow use case but create new administrative burden, require duplicated effort, or fail to support reimbursable models such as remote patient monitoring, chronic care management, or clinician-directed virtual services. The stronger approach is to invest in technology that can serve multiple populations and care settings while supporting long-term adoption.

Why the benefits of the Dr. Miltie N9+ fit these funding priorities

The benefits of the Dr. Miltie N9+ become clearer when viewed against these pillars. For Mississippi healthcare organizations, the value is not simply that the platform supports telehealth. It is that it supports more clinically useful, scalable, and patient-centered virtual care.

It extends clinical reach beyond video-only care

A common limitation in rural telehealth programs is that video alone may support conversation but not enough examination. The Dr. Miltie N9+ is designed to help clinicians perform remote physical assessments and capture clinically relevant patient information in distributed settings. That matters in Mississippi communities where access gaps are often driven by distance, specialist scarcity, or transportation burden.

For health systems and rural providers, that expanded clinical capability can make virtual encounters more actionable. Instead of using telehealth only for low-acuity check-ins, organizations can support broader assessment, earlier intervention, and more appropriate triage.

It supports pediatric and family-centered care

Pediatric access is a practical and emotional issue for many Mississippi families. Long travel times can disrupt school, work, and caregiver schedules. For autistic children and pediatric patients with special healthcare needs, the burden is not only logistical. A clinical encounter in an unfamiliar environment can also increase stress and reduce cooperation.

The Dr. Miltie N9+ supports care in familiar settings where children may be more comfortable and caregivers can participate more fully. That can improve exam quality, support follow-up adherence, and give pediatric providers a more realistic view of how the child is doing in daily life. For organizations building pediatric access strategies, that is not a minor advantage. It directly affects care delivery.

It aligns with rural workforce realities

Mississippi providers are under pressure to do more with limited clinical staff. Any technology that depends on major workflow disruption or highly specialized deployment can be difficult to sustain. The stronger model is one that helps existing teams extend their reach, standardize parts of care delivery, and support clinician-directed services across multiple locations.

Connected virtual examination and remote monitoring can help organizations use physician, advanced practice, nursing, and care coordination resources more effectively. The exact staffing model depends on the setting, but the principle is consistent: if the platform improves the quality of remote interaction and supports care between visits, workforce efficiency improves without reducing clinical oversight.

Implementation questions Mississippi leaders should ask

A funding-aligned purchase decision is rarely about features alone. Leaders should ask whether the platform can support their target populations, fit reimbursement pathways, and scale across settings such as clinics, schools, community sites, and homes.

They should also examine where the greatest return is likely to come from. For one organization, the highest value may be pediatric specialty reach. For another, it may be chronic disease follow-up, remote patient monitoring, or post-discharge support in rural communities. The right deployment strategy depends on the care gaps being targeted.

Not every use case is equal

This is where nuance matters. A hospital seeking to reduce avoidable transfers may prioritize virtual assessment capability. A federally qualified health center may care more about continuity, chronic care management, and caregiver engagement. A pediatric program may focus on follow-up access for special populations. The same platform can support different transformation goals, but the implementation plan should be specific.

Technology also needs executive sponsorship and operational ownership. Even strong tools underperform when they are treated as isolated IT projects instead of care delivery infrastructure.

From funding logic to care model design

The best way to think about RHTP-related investment is not, “What can we buy with this funding?” A better question is, “What care model can we build that remains valuable after the funding cycle ends?”

That is where a connected-care approach has real strategic advantage. When virtual examination, remote patient monitoring, caregiver participation, and care coordination are designed as part of one operating model, organizations are better positioned to improve access and produce measurable value. They are also less likely to end up with fragmented digital tools that clinicians do not want to use.

For Mississippi providers serving rural and underserved communities, the benefits of the Dr. Miltie N9+ are strongest when the technology is treated as part of a broader transformation effort. One example is Dr. Miltie’s Circle of Care™ model, which reflects the practical reality that better outcomes often depend on connecting clinicians, patients, caregivers, and community-based care settings rather than limiting care to a single site.

Mississippi’s rural health challenges will not be solved by funding alone. They will be shaped by whether healthcare organizations use that funding to build care models that are clinically credible, financially sustainable, and easier for patients and families to access. The most durable investments are the ones that help providers bring real care closer to the people who need it.

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In a letter submitted to the Senate Finance Subcommittee on Health for a hearing Nov. 14, the AHA expressed support for the CONNECT Act (S.2016/H.R. 4189) and urged Congress to allow Medicare beneficiaries to access telehealth services wherever they and their providers are and allow rural health clinics, federally qualified health centers and critical access hospitals to serve as distance sites. AHA also encouraged Congress to: expand eligible telehealth providers to include occupational and physical therapists, speech-language pathologists and audiologists; no longer require beneficiaries to receive an in-person evaluation six months before and annually after initiating behavioral telehealth treatment; explicitly cover audio-only services; allow providers to use telehealth services to recertify hospice patients; and streamline licensure requirements for providers operating across state lines.
 
Testifying at the hearing were representatives from: the Northwest Regional Telehealth Resource Center; University of Alabama at Birmingham; University of Michigan; and Harvard Medical School.

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AHA on Oct. 10 voiced support for the CONNECT for Health Act (S. 2016/H.R. 4189), legislation that would increase patient access to telehealth services while removing barriers to adoption. The bill would permanently remove geographic restrictions that limit where patients can access telehealth, add homes and other clinically appropriate originating sites, and allow rural health clinics and federally qualified health centers to serve as distant sites. It also would remove requirements for an in-person evaluation six months before initiating behavioral telehealth treatment and an in-person visit annually thereafter.

AHA encouraged the legislation’s House and Senate sponsors to consider eliminating restrictions on originating sites altogether, and allowing critical access hospitals to offer and bill for telehealth services and serve as distant sites.

“Hospitals, health systems, providers and patients have seen the benefits and potential for telehealth to increase access and transform care delivery,” AHA wrote. “We appreciate your leadership on this important issue and look forward to working together to ensure passage of the CONNECT for Health Act of 2023.”

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America, and for that matter the world, is facing a growing challenge in caring for two expanding groups of patients — those 60 and older and patients with such chronic diseases as cancer, diabetes and obesity.

Across the globe, the 60-and-older population is increasing quickly and will surpass 2 billion by 2050, according to the World Health Organization. Meanwhile, caring for the 60% of U.S. adults who have at least one chronic disease accounts for $3.7 trillion in annual health care costs, states the Centers for Disease Control and Prevention.

The ability to monitor health and deliver care outside traditional medical settings could significantly reduce this expenditure, notes a recent CB Insights report. The analysis examines home care tech markets that providers should prioritize over the next three to five years.

We explore some technologies CB Insights analysts say providers should scrutinize over the next one to three years and what’s been happening in these sectors.

4 Home Care Technologies to Explore

1 | At-home Infusion

This technology enables patients to have intravenous treatments like dialysis at home. Wirelessly connected infusion pumps share data with providers to platforms that monitor treatment regimens. Providers are turning to these devices to support convenient, consumer-focused care. Investments in this tech sector are up significantly over the last two years, with mega funding rounds going to Somatus ($325 million), Quanta Dialysis Technology ($245 million) and Monogram Health ($160 million).

Key Takeaway

Providers should be selective before investing in this technology to ensure that comprehensive solutions support key considerations like ease of administration, infection monitoring and prevention, and tools to determine post-infusion status, the report states.

2 | Virtual Clinical Exam Rooms

Exam tools ranging from digital stethoscopes to comprehensive digital medical kits provide diagnostic-quality equipment to the home to support virtual visits. The virtual care equipment market was worth $3.5 billion in 2021, according to a Global Market Insights report and is estimated to grow at a compound annual growth rate of 17.3% through 2028.

Key Takeaway

Advanced exam tools, especially those with built-in artificial intelligence, will become a more prominent component to support remote diagnosis and treatment decisions.

3 | Digital Therapeutics

These solutions combine evidence-based research with digital technologies to provide treatment options for ongoing medical issues that can be addressed in the home. The technology provides apps and digital tools to support issues ranging from mental health to the management of diseases related to gastroenterology, endocrinology and cardiology. Digital therapeutics companies have received more than $1.1 billion in funding over the past five years and the sector is evolving quickly as Food and Drug Administration-approved, clinically validated therapies find their way to the market.

Key Takeaway

Monitor this sector to identify therapies that deliver benefits across multiple specialties and conditions. Evaluate the technology based on ease of use, whether the solutions provide easy-to-grasp content and meet the disparate needs of the populations you serve.

4 | Home Care Management Platforms

This technology supports the transition from an acute care setting to the home to help ensure effective care coordination. These platforms traditionally have focused on care for those with chronic conditions and the elderly, but newer solutions also focus on parents who are caring for infants. The technology ranges from supporting the scheduling of ongoing care to monitoring whether patients have been attending to existing care needs.

Key Takeaway

Evaluate these systems to ensure that investments will fit with your comprehensive growth strategy for managing multiple patient populations, including the elderly, patients with chronic diseases and acute care patients.

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Telehealth Access for America, an AHA-supported campaign to protect patient access to critical telehealth services, urged Congress to make permanent certain Medicare telehealth flexibilities granted during the COVID-19 public health emergency and extended through 2024 by the Consolidated Appropriations Act.

“This temporary extension was welcomed news for patients and providers alike, but remains just that – a temporary solution,” TAFA wrote. “According to a recent study, nearly three-in-four virtual care users want Congress to make current telehealth flexibilities permanent. The patients and organizations we represent need certainty that only Congress can provide. It is in the best interest of patients and providers nationwide that Congress make telehealth a permanent piece of the health care puzzle.”

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Jeff Lagasse, Associate Editor

The American Hospital Association has come out in support of bipartisan legislation, introduced in the House of Representatives, that would require the Department of Health and Human Services, Medicare Payment Advisory Commission, and Medicaid and CHIP Payment and Access Commission to study expanded telehealth use during the COVID-19 pandemic and recommend potential enhancements to telehealth access and quality.

In a letter to Republican Ohio Representative Troy Balderson, the AHA said it backed H.R. 1110, the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act.

The legislation mandates that HHS, MedPAC and MACPAC each conduct a report and issue recommendations on telehealth. These reports will include the expansion of telehealth services during the COVID-19 outbreak, the uptake of those services by patients across the country, and recommendations for enhancing the quality of and access to these services. 

The bill also asks each entity to make recommendations for potential improvement and expansion, as well as approaches to address and prevent fraudulent activity.

Last week, Balderson said this data is “crucial” for Congress to legislate a permanent expansion of telehealth.

“Telehealth is helping to better connect patients and providers by reducing the need for long-distance travel for routine in-person care and consultations,” said Balderson, who introduced the bill along with Representatives Susie Lee (D-NV), Ashley Hinsno (R-IA) and Joe Neguse (D-CO).

The AHA concurred.

“Telehealth has provided a critical way for patients to continue to access needed care, particularly during the COVID-19 pandemic,” the organization wrote in its letter. “We greatly appreciate the flexibilities implemented during the public health emergency and recently extended through 2024, as they will allow hospitals and health systems to continue to provide virtual care for patients.”

WHAT’S THE IMPACT

In order to help beneficiaries maintain access to care amid stay-at-home orders aimed at reducing COVID-19 related exposure, the Centers for Medicare and Medicaid Services used emergency waiver authorities enacted by Congress, as well as existing regulatory authorities, to implement policies expanding access to telehealth services during the pandemic.

These included waiving several statutory limitations, such as geographic restrictions, and allowing beneficiaries to receive telehealth in their home. 

The omnibus spending package that passed in December extended telehealth – and hospital-at-home programs – beyond the end of the public health emergency. The legislation extends waivers for both programs. Telehealth flexibilities are now in effect through the end of 2024.

Outside of the public health emergency, Medicare is generally restricted to payment for telehealth services in certain, mostly rural areas, and when beneficiaries leave the home and go to a clinic, hospital or other medical facility for the service.

In the physician fee schedule rule released in November, CMS announced that for the first time outside of the COVID-19 PHE that Medicare would pay for mental health visits furnished by Rural Health Clinics and Federally Qualified Health Centers via interactive video-based telehealth, including audio-only telephone calls.

THE LARGER TREND

In October 2022, after three months of relative stability, national telehealth utilization declined 3.7%. Looking at one specific metric, telehealth went from 5.4% of medical claim lines in September, to 5.2% in October, according to FAIR Health’s Monthly Telehealth Regional Tracker.

The decline in telehealth utilization was larger than the national average in the South (6.8%), Midwest (4.9%) and West (4.1 %), while there was an increase in utilization of 1.7% in the Northeast.

The data represents the privately insured population, including Medicare Advantage and excluding fee-for-service Medicare and Medicaid.

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Noah Schwartz – Friday, February 24th, 2023

The American Hospital Association is backing legislation that would require the HHS, Medicare Payment Advisory Commission, Medicaid and CHIP Payment and Access Commission to study the expanded use of telehealth during the COVID-19 pandemic.

The legislation, titled “Knowing the Efficiency and Efficacy of Permanent Telehealth Options Act,” is sponsored by a bipartisan group of representatives, according to a Feb. 23 AHA news release.

“Making the coverage of telehealth services permanent is critical for hospitals and health systems to deliver more convenient access and care to as many patients as possible while improving satisfaction and outcomes,” Lisa Kidder Hrobsky, AHA’s senior vice president of advocacy and political affairs said in the release.

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As the Congressional Telehealth Caucus considers updates to legislation that would permanently remove all geographic restrictions on Medicare telehealth services and expand originating sites, AHA encouraged House and Senate caucus leaders to consider adding provisions that have expanded access to care during the COVID-19 public health emergency. 

Specifically, AHA highlights support for provisions to permanently eliminate originating and geographic site restrictions and expand eligible provider types; repeal the in-person visit requirement for behavioral telehealth and distant site restrictions on Federally Qualified Health Centers and Rural Health Clinics; reimburse on a par with in-person visits; continue payment and coverage for audio-only services; remove unnecessary barriers to licensure; establish a Drug Enforcement Administration special registration process for administering controlled substances via telemedicine; and expand cross-agency collaboration on digital infrastructure and literacy initiatives.

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Update: President Joe Biden signed the bill into law on Dec. 29, 2022. 

Update: The bill passed both chambers of Congress and was sent to President Joe Biden as of Dec. 23, 2022. 

The year-end $1.7 trillion spending bill includes provisions to extend pandemic-era telehealth and hospital-at-home waivers for two years.

The legislation, released Tuesday, aims to avert a government shutdown and includes several healthcare provisions, including reducing the 2023 Medicare payment cuts to 2 percent from 4.5 percent.

In a win for telehealth proponents, the sweeping bill also includes a two-year extension of telehealth-related regulatory flexibilities for Medicare beneficiaries put in place during the COVID-19 pandemic. A previous bill extended these flexibilities for five months after the public health emergency expires.

Now, the waivers will remain in place through Dec. 31, 2024, if the legislation passes both the House and Senate and is enacted into law.

The flexibilities include eliminating geographic restrictions on originating sites for telehealth services, enabling Medicare beneficiaries to receive services from any location, and allowing federally qualified health centers and rural health centers to continue providing telehealth services.

Further, the waivers lift the initial in-person care requirements for those receiving mental healthcare through telehealth and allow for continued coverage of audio-only telehealth services.

In addition to extending the Medicare telehealth waivers, the new legislation includes a two-year extension of the Acute Hospital Care at Home Program. Introduced in November 2020 by the Centers for Medicare and Medicaid Services, the Acute Hospital Care at Home Program allows treatment for common acute conditions in home settings. As of Dec. 16, 259 hospitals across 37 states were participating in the program.

The safe harbor for telehealth coverage for those with high deductible health plans (HDHPs) with health savings accounts (HSAs) will also be extended by two years if the new bill passes. The safe harbor provision enables people with HDHP-HSAs to receive telehealth coverage without meeting their annual deductible first.

“Today, our Congressional telehealth champions on both sides of the aisle came through for the American people and for ATA and ATA Action members, by meeting our plea for more certainty around telehealth access for the next two years, while we continue to work with policymakers to make telehealth access a permanent part of our healthcare delivery for the future,” said Kyle Zebley, senior vice president of public policy at American Telemedicine Association and executive director of the association’s advocacy arm, ATA Action, in an emailed press release.

But the new legislation does not include a similar two-year extension for the waiver of the Ryan Haight Act.

The Ryan Haight Act of 2008 required providers to meet with a patient in person before being allowed to prescribe controlled substances for that person via telehealth. The in-person visit requirement was temporarily lifted during the COVID-19 pandemic.

Since then, several stakeholders, including the American Telemedicine Association and American Psychiatric Association, have asked that Congress permanently eliminate the Ryan Haight Act.

The latest spending bill does, however, direct the Drug Enforcement Administration (DEA) to create final regulations regarding the circumstances under which a special registration for telemedicine may be issued. Providers obtaining a special registration for telemedicine would be allowed to waive the in-person visit requirement.

Earlier this month, the American Hospital Association had also asked that the DEA clarify regulations for the special registration process and provide recommendations for an interim plan.

“…the hard work continues, as we persist in pressing telehealth permanency and creating a lasting roadblock to the ‘telehealth cliff,'” said Zebley. “Additionally, we will continue to work with Congress and the Biden administration to make sure that a predictable and preventable public health crisis never occurs by giving needed certainty to the huge number of Americans relying on the clinically appropriate care achieved through the Ryan Haight in-person waiver.”

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The House and Senate  Appropriations Committees last night released the fiscal year 2023 Omnibus Appropriations legislation that would fund the government through Sept. 30, 2023. The bipartisan bill includes various provisions beneficial to hospitals and health systems.  
 
The legislation would:  

• Prevent the 4% Statutory Pay-As-You-Go (PAYGO) sequester for two years; 
• Extend for two years critical rural Medicare programs, telehealth flexibilities and the Acute Hospital Care at Home; 
• Reduce the physician fee schedule cut from 4.5% to 2% for 2023 and approximately 3% for 2024; 
• Provide 200 additional Medicare-funded graduate medical education positions, half of which would be dedicated to psychiatry and psychiatry subspecialty residencies; 
• Take several steps to improve access to behavioral health services; 
• Make improvements to the government’s ability to prepare for future emergencies. 

 
In a statement released today, AHA President and CEO Rick Pollack said, “The AHA is pleased that on a bipartisan basis Congress recognizes the immense pressure America’s hospitals, health systems and our caregivers are facing. This legislation will deliver critical support and resources so we can better care for our patients and create healthier communities. Due to skyrocketing cost increases for supplies, equipment, drugs and labor, challenging workforce shortages, and the ‘tripledemic’ of COVID-19, flu, and RSV, the hospital field is stretched thin and on the brink.  
 
“Specifically, we are pleased that this bill prevents significant four percent Medicare PAYGO cuts to providers, extends two key programs for two years that help rural hospitals keep their doors open, and extends for two years critical waivers for telehealth and hospital-at-home programs that have led to improvements in care and made medical treatment more convenient and accessible for patients. Additionally, we appreciate Congress giving partial relief to physicians by rolling back Medicare payment cuts and including important provisions to improve the nation’s preparedness for the next pandemic, train the next generation of caregivers, bolster behavioral health care providers and expand access to behavioral health services. Finally, helping states prepare for changes in Medicaid eligibility due to the end of the Public Health Emergency could help them transition those individuals to other forms of health coverage. 
 
“However, this is just a part of what needs to be done to support those on the front lines caring for patients. In the new year, we will continue to advocate for Congress and the Administration to take action to address patient discharge backlogs, support our current workforce and increase the pipeline into the future, hold commercial health insurers accountable for policies that compromise patient safety and add burden to care providers, and strengthen hospitals that care for a disproportionate number of patients covered by government programs or are uninsured, to name a few of our priorities.”  
 
The Senate is expected to begin debate on the measure today and to pass the spending bill first. The House is likely to vote by Friday. The president is expected to sign the bill into law before current funding for the government expires at 11:59 p.m. ET on Dec. 23.

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