Mississippi’s $500 million plan for transforming rural health care over the next five years includes collaboration between providers, expanding the medical workforce, advancing health technology and closing gaps in care. But details about specific programs to accomplish those goals were sparse. 

“While Mississippi has long faced challenges in delivering access to quality health care in rural areas, our plan is designed to address those challenges head-on,” Republican Gov. Tate Reeves said during a press conference Tuesday. 

The funding will be doled out to states over five years as part of the one-time federal $50 billion Rural Health Transformation Program, beginning in 2026. Mississippi is expected to receive at least $500 million – and possibly more – as a part of the program, the governor said. 

Virtually every county will be included in the plan, which will be implemented with a focus on transparency and evaluating outcomes, said Reeves, who will oversee and coordinate the program. A third-party organization will assist with deploying funds, tracking milestones and assessing outcomes, and the governor’s office will work closely with the Mississippi Department of Health and Division of Medicaid, Reeves said. 

Reeves called the application process a “60-day sprint.” Guidelines for the funding were released bv the Centers for Medicare and Medicaid Services Sep. 15, giving states less than two months to submit a proposal. Awards will be determined by the end of the year. 

Mississippi’s plan includes six initiatives: 

• A comprehensive statewide assessment to study rural health care needs today and for the next 10 years, conducted by a third-party. Reeves did not say how the third-party would be chosen. 
• Coordinated regional integrated systems to create a data-driven network for emergency, clinical and community-based services. 
• Workforce expansion through targeted programs that address recruitment, retention, training and career pathway development for health care professionals.
• Health technology advancement to modernize rural health care systems by strengthening a digital backbone that supports high quality, coordinated and secure care. 
• Telehealth adoption and provider support designed to strengthen rural health care by increasing virtual care access, assisting providers with telehealth adoption and exploring innovative payment models.
• Building rural health infrastructure to improve access to specialized care, close care gaps and support innovative pilot programs aimed at enhancing health care delivery and improving outcomes. 

Reeves said the state’s full application would not immediately be made public. The state will work with the Centers for Medicare and Medicaid Services to determine when part or all of the plan can be released, he said. 

The funding program for rural health was tacked on to President Donald Trump’s tax-and-spending law passed this summer, which is expected to result in significant losses to federal Medicaid spending in rural areas. Congressional Republicans added the one-time money for rural health to soften the blow associated with the cuts. 

An estimated $137 billion in cuts to federal Medicaid spending are expected in rural areas over 10 years, meaning Rural Health Transformation Program funds will offset just over a third of the cuts, according to analysis from KFF. 

More than half of Mississippi’s rural hospitals are at risk of closing, according to a recent report by the Center for Healthcare Quality and Payment Reform. Hospital leaders have warned that the federal cuts could force some rural hospitals to stop some services or close their doors altogether. 

In Mississippi, cuts to state-directed payments, which help hospitals offset low Medicaid payments, will amount to a loss of $160 million a year statewide beginning in 2029, Mississippi Medicaid Director Cindy Bradshaw said previously. 

Some critics have called the funding program a “Band-Aid,” emphasizing that it is temporary and will not cover all of the losses hospitals are expected to bear as a result of cuts to Medicaid in rural areas.

The state’s plan for the Rural Health Transformation Program will not include direct financial assistance to hospitals, which the federal government has made clear it will not approve, Reeves said. 

“Every facility in our state is going to have to continue to think through what exactly their business model looks like,” he said. “And hopefully, that will lead to some efficiencies.” 

Half of the $50 billion program will be distributed evenly among all states with approved applications. The other half will be calculated based on a formula that calculates each states’ rurality, the quality of its application and alignment with Make America Healthy Again policies. 

Mississippi has recently taken steps to adopt policies that receive higher scores, including reestablishing the Presidential Fitness Test in schools and seeking a waiver to restrict purchases of sugary foods and drinks through the Supplemental Nutrition Assistance Program, or SNAP.

Mississippi is likely to receive a large share of funding based on the Centers for Medicare and Medicaid Services rubric, according to experts. Mississippi scores sixth out of all states, according to estimates by the Cecil G. Sheps Center for Health Services Research at the University of North Carolina. That means the state is likely to receive a larger sum of money from the program. 

Some state lawmakers have expressed frustration that they have not been more involved in crafting the state’s proposal, noting that they have the responsibility of appropriating the funds. 

House Speaker Jason White said legislators should have input on the plan during a state budget hearing Sep. 24. Weeks later, at the Medicaid Advisory Committee meeting Oct. 17, Medicaid Chair Rep. Missy McGee, a Republican from Hattiesburg, said legislators would like to see the plan.

Reeves said Tuesday legislators have been engaged in crafting the plan, as have other stakeholders, including the Department of Education, Department of Mental Health, the Mississippi Band of Choctaw Indians and other partners.

“We’ve had extensive conversations with legislators and legislative leaders over the last short while,” Reeves said. “…Obviously, this plan doesn’t happen in a vacuum. We’ve been having conversations with them.” 

The program is not just about spending a lot of federal money, said State Health Officer Dr. Dan Edney.

“As the outcomes in our rural counties begin to improve, the outcomes for the state will continue to improve,” he said Tuesday. “And as we improve rural health care, we improve all health care in the state.”