Introduction: The Opportunity in Front of Us

The One Big Beautiful Bill Act (H.R. 1), passed on July 4, 2025, fundamentally changes the healthcare funding landscape. While it significantly reduces Medicaid funding, it also brings unprecedented federal support for rural healthcare. Central to it is the Rural Health Transformation Program, a $50 billion fund, $10 billion annually, for states that submit and receive approval for transformation plans (Holland & Knight, 2025; Rural Health Transformation Program Summary, 2025). Mississippi stands to receive at least $100 million, and potentially another $100 million, if the state demonstrates measurable progress in efficiency, patient outcomes, and technology adoption (Senator Hyde-Smith, 2025; Rural Health Transformation Program Summary, 2025). This funding is not open-ended. It comes with expectations of rigor, accountability, and sustainability. Projects must show results and a pathway to stand on their own once federal support tapers off. Notably, EMS has been designated as a priority within the state’s funding stream. This creates a chance to deliver lasting transformation and modernization for EMS.

Linking to the Bigger Picture: EMS’s Evolving Role

In my previous article I called EMS the “Green Berets of healthcare”, teams that go where others cannot, adapt to chaos, and build community capacity. That view is truer than ever. The moment provides an opportunity to prove that EMS is capable of so much more than 911 response and transfers. Instead, functioning as a full partner in healthcare delivery, equipped for prevention, integration, and innovation.

Why EMS Should Lead This Effort

EMS is healthcare delivery. It is a true healthcare navigator with the ability to match patient needs with available resources. It delivers care in every county and community. That availability and commitment drive trust and it creates opportunities to expand EMS’ position in healthcare. By improving EMS performance and outcomes, we not only help patients, but also ease strain on hospitals, primary care practices, and public health systems across the state.

Areas Where EMS Can Deliver Results

This funding stream is not a way to support ideas that are five to 10 years to bring to fruition. The projects must be real, effective and immediate. There are three main categories EMS must consider for projects. They must focus on: Integrating Emerging Technology and Coordination of Care; Improving health outcomes; and Workforce development. EMS can clearly deliver in all three of these categories.

Integration of Emerging Technology and Data-Driven Coordination of Care:

One of the most glaring gaps in Mississippi’s healthcare system is poor resource coordination. States like Alabama, Louisiana, and Georgia have already put centralized tracking systems to work. Alabama’s Trauma Communications Center manages trauma center availability and patient routing in real-time. Louisiana’s Emergency Response Network (LERN) connects EMS to appropriate hospitals across trauma, stroke, and STEMI care systems and supports disaster transfers. Georgia’s Coordinating Center (formerly the Regional Coordinating Center) tracks hospital bed status and emergency department diversion in real-time to support EMS transport decisions.

Mississippi can build on those models by creating a statewide communication and coordination center that monitors bed availability statewide, coordinates and facilitates patient transfers, and coordinates emergent and routine movements. Such a system would allow trauma patients to be tracked seamlessly from the scene through discharge, ensuring continuity of care. It would identify resources and decrease transfer times for STEMI and Stroke patients, dramatically improving outcomes. It would also prevent the all-too-common bottlenecks that strain hospitals and EMS agencies. For example, imagine a 2 a.m. request to transfer a fractured hip for orthopedic consultation. A central hub could immediately identify that the receiving hospital was nearing capacity after taking in four other critical patients and coordinate a safe transfer delay until the following morning. This relieves unnecessary stress on emergency departments, reduces wasted transport resources, and improves outcomes by aligning patient needs with system capacity.

Beyond coordination, the hub would generate measurable, data-driven results. This is exactly the information needed to justify continued funding, improve system design, and support clinical decision making. With the integration of modern technology and artificial intelligence, Mississippi could optimize when and where transfers should occur, creating a smarter, more responsive system. This is not an abstract idea; it is an attainable solution that could transform the efficiency and accountability of healthcare delivery statewide. Why should EMS lead the way in creating this? Simple, this is a natural fit for EMS because we already excel at resource management. EMS professionals understand patient movement, telecommunications, and workload analysis. With the right tools, EMS can help ensure rural patients reach the right care at the right time.

Improving Health Outcomes:

In 2024 the Mississippi legislature passed HB 1489 the Mississippi Triage, Treat and Transport to Alternative Destination Act which creates the structure for EMS to expand our ability to fund a new way of managing patients. Community paramedicine programs can move that into an expanded and comprehensive plan which connects primary care to the patient in their homes. It can help relieve emergency department overuse by managing chronic illnesses such as diabetes, congestive heart failure, COPD at home. It can also provide follow-up care after discharge of certain patients to reduce readmissions. Again, this is immediately achievable and produces measurable results. The limiting factor has always been funding and resources. We have an opportunity to address both of those issues.

Integration of next generation telehealth technology must be included in any plan. It may not have a significant role in 911 calls. Here EMS clinicians are capable of making informed clinical decisions based on patient assessment and clinical guidelines. However, in community-care settings it can bridge gaps where Community Paramedics can consult with primary care physicians and specialists to decide whether a patient needs transport, can stay home safely with additional treatments prescribed, or identify the need for additional social or medical resources such as home health. Not only would a comprehensive telehealth program impact EMS, but implementation of state-wide system where rural hospitals could connect with specialist would create a seismic shift in patient outcomes. Combining state-wide telehealth with a central communication and coordination center creates a synergy which will dramatically impact quality of care.

Workforce development:

The urgency of addressing the shortage of EMS providers cannot be understated. While degree-based paramedic and community paramedic licensure are achievable goals, the immediate need is an expanded EMS workforce across all provider levels. The only way to achieve this is by tripling the number of EMTs in the workforce. Many of those EMTs will further their education and become Advanced EMTs or Paramedics. Previously, focus has been placed on the paramedic shortage. This is focusing on the finish line, without ever preparing for the beginning of the race. Expanding the EMT numbers this dramatically will require accessible, non-traditional training methods and clear metrics for success. We must remember that any projects funded through this bill must be transformative, impactful and sustainable. Therefore, we must also focus on retaining people in the workforce. One simple way to change the perspective is by recognizing EMS professionals in a manner consistent with other healthcare professions. These clinicians must be licensed, not certified. Thereby raising professional parity and improving career longevity and advancement. Recruiting and retaining EMS professionals is complex. Changing the terminology from certification to licensure is a small but important step in the right direction. It will take a comprehensive approach, but improvements and sustainability can be achieved.

Accountability: The Key for the Second $100 Million

The second half of the funding is not guaranteed, it hinges on data showing real improvement across all funded projects, including EMS. “Feel-good” initiatives won’t pass muster. All programs must be founded in evaluation: tracking ER visits, hospital admissions, patient outcomes, and cost savings. EMS programs must also align with other rural health projects, so the system as a whole improves, not simply isolated areas.

Closing Call to Action

EMS stands at a crossroads and Mississippi EMS can lead the nation. Providers must step into expanded roles, ready to embrace the future and deliver measurable results. Leadership must design programs with accountability, sustainability, and coordination built in. Policymakers must see EMS as the linchpin for rural health and prioritize it in transformation plans. Together, with focus and urgency, we can secure funding and, more importantly, transform EMS from just a response system into the backbone of rural healthcare delivery for generations to come.

We will continue to provide updates in the coming months as projects are identified, and funding is confirmed. The future of EMS is now.

References

Holland & Knight. (2025, July 11). One Big Beautiful Bill Act Includes $50 Billion Rural Health Transformation Program. Holland & Knight. Holland & Knight

Rural Health Transformation Program Summary. (2025). Rural Health Transformation Program Summary. National Rural Health Association. National Rural Health

Senator Hyde-Smith. (2025). One Big Beautiful Bill. [Press release]. Senator Cindy Hyde-Smith

Mississippi Legislature. (2024). Mississippi Triage, Treat and Transport to Alternative Destination Act, H.B. 1489. Enacted May 2, 2024.