RFI_RPM_and_Telehealth_Missouri_ DSS_8.24.26.pdf

Missouri Department of Social Services

REQUEST FOR INFORMATION:

RFI FOR RURAL HEALTH TRANSFORMATION PROGRAM (RHTP)

REMOTE PATIENT MONITORING & TELEHEALTH SOLUTIONS

Issued by:

Missouri Department of Social Services (DSS) MO HealthNet Division

RFI Point of Contact:

Steven Hoffman Procurement Specialist

Steven.Hoffman@dss.mo.gov

Issued on:

August 24, 2026

Reponses are requested by:

September 09, 2026, by 2:00 pm (CDT)

THIS IS A REQUEST FOR INFORMATION (RFI) ONLY.

THIS IS NOT A FORMAL BID SOLICITATION

NO AWARDS WILL RESULT

This RFI does not constitute a solicitation of proposals, a commitment to conduct procurement, an offer to contract, or a prospective contract.

Costs incurred by the vendor: The Missouri Department of Social Services is not liable for any costs incurred by respondents to produce and submit a response to this RFI.

Procurement Authority: Missouri procurement authority is established in Chapter 34, RSMo. This procurement authority requires the application of consistent and sound public procurement practices in the acquisition of products and services.

State Technical Standards: Any future solicitation request based on this RFI will require the vendor and solution to comply with all state technical standards

The Rural Health Transformation Program information provided by the Missouri Department of Social Services is supported by the Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $216,276,817.66, with 100 percent funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CMS/HHS, or the U.S. Government.

mailto:Steven.Hoffman@dss.mo.gov

Contents

1.0 Introduction

2.0 Vendor Response Submission, Vendor Questions and Open Records

3.0 Purpose, Background/Current State, Future State

4.0 Scope, Requirements and Data Integration Needs

5.0 Questions for the Vendor

6.0 Acronyms and Abbreviations

Appendix A – Vendor Response Cover Page…………………………………….……………………….…………………………….……….10

1.0 Introduction

1.1 Introduction and Purpose: For the Rural Health Transformation Program (RHTP), the Missouri Department of Social Services (DSS) has decided to issue a single RFI for Telehealth and RPM. The purpose of the RFI is to help inform DSS's approach, implementation considerations, and anticipated costs for each technology. Given that Telehealth and RPM support distinct use cases, the RFI clearly differentiates the requirements and considerations applicable to each.

DSS is seeking information from the vendor community to better understand the services available to support the implementation of (1) Remote Patient Monitoring (RPM) and (2) Telehealth across rural providers as part of the Rural Health Transformation Program. This RFI seeks information from respondents on their capabilities regarding services and technical components on (1) RPM and (2) Telehealth.

Rural communities often lack consistent access to both maternal health oversight and specialty expertise.

Remote patient monitoring can extend care beyond the clinic by allowing care teams to follow maternal health indicators between appointments and respond sooner when risks emerge. At the same time, telehealth can equip small rural hospitals with direct access to specialists, helping local clinicians manage complex cases and avoid unnecessary patient transfers. Through this RFI, DSS is seeking solutions that improve continuity of maternal care, strengthen clinical decision-making, and expand the range of services available within rural hospitals.

In response to this RFI, vendors may provide high level overviews of their solution, however, the state seeks sufficiently detailed information to be able to understand the full range of services available. In response to this RFI, vendors are encouraged to provide concise yet sufficiently detailed information describing their solution capabilities, implementation approaches, and service offerings. The state also requests an estimate of pricing for budgeting purposes only.

The State of Missouri sincerely appreciates your interest in supporting this important initiative. For more information on the Missouri RHTP, please visit: https://mydss.mo.gov/mhd/rural-health.

2.0 Vendor Response Submission, Vendor Questions and Open Records

2.1 Vendor Response Submission & Format: To ensure full consideration, vendor responses must be emailed to Steven.Hoffman@dss.mo.gov on or before 2:00 pm (CDT), [September 09, 2026].

• Cover Page: Vendors must complete the Vendor Response Cover Page (Appendix A) and include it as the first page of their submitted response.

• Subject Line: Responses must contain the subject line: "RHTP RFI - Track 1 (RPM) - [Vendor Name]" OR "RHTP RFI - Track 2 (Telehealth) - [Vendor Name]". (Note: Vendors responding to both tracks must submit two separate emails with the appropriate subject lines.)

• Format: Responses should be provided in a portable format (Microsoft Word or PDF), formatted using Times New Roman size 11 font, one-inch margins, and consecutively numbered pages using a consistent numbering format. All pages of the response should include the RFI title consistently in either the footer or header of each page.

• Length: The primary response should be limited to 15 pages. Cover pages (including Appendix A), tables of contents, and pre-existing technical or marketing appendices will not count toward this page limit.

2.2 Vendor Questions: Questions regarding this RFI must be submitted via email to Steven.Hoffman@dss.mo.gov . If a Project Manager is assigned to the RFI, include the Project Manager's name and email address on all correspondence.

2.3 Open Records/Sunshine Laws & Proprietary Information: Responses and all supporting information/materials submitted must be non-proprietary and non-confidential. Vendors are advised that responses to this Request for Information (RFI) will be considered open records under section 610.021 RSMo and can be published in the public domain or shared upon request. The State of Missouri does not guarantee protection of any information from public disclosure. Responses provided will become the property of the State of Missouri.

https://mydss.mo.gov/mhd/rural-health

More information regarding the Missouri Sunshine Law can be found at https://ago.mo.gov/get-help/programs-services-from-a-z/sunshine-law/.

2.4 Vendor Demonstrations: The State reserves the right to invite select respondents to provide a live demonstration or participate in a follow-up interview to further explain their solution. Participation in a demonstration would be strictly voluntary, for informational and market research purposes only, and will not result in a contract award.

2.5 Public Statements and Press Releases: Steven’s Amendment – In accordance with the Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations Act, Public Law 101- 166, Section 511, “Steven's Amendment”, the contractor shall not issue any statements, press releases, and other documents describing projects or programs funded in whole or in part with Federal funds unless the prior approval of the Department is obtained. Any statement, press release, or other document describing projects or programs funded with federal funds shall clearly state the following as provided by the Department:

a. The percentage of the total costs of the program or project that will be financed with Federal funds;

b. The dollar amount of Federal funds for the project or program; and

c. The percentage and dollar amount of the total costs of the project or program that will be financed by nongovernmental sources.

3.0 Purpose, Background/Current State, Future State

3.1 Purpose: The purpose of this RFI is to gather information from qualified RPM and telehealth solution providers to inform the State’s strategy for evaluating and potentially implementing RPM and telehealth technologies across rural healthcare providers in Missouri.

Through this RFI, we are seeking solutions across two distinct tracks. The Remote Patient Monitoring track will focus on supporting maternal care by enabling providers to monitor patients between visits, identify emerging risks, and intervene earlier. The Telehealth track will focus on connecting rural hospitals and providers with specialists to strengthen clinical decision-making, expand access to expertise, and reduce unnecessary patient transfers. Solutions proposed under either track should be scalable, practical to implement, and adaptable to the staffing, financial, and technical realities of rural healthcare settings.

Through this RFI, the State seeks detailed information on system capabilities, integration and interoperability, technical requirements, security and governance, implementation approach, rural-aligned pricing, and ongoing support services. Information collected will inform the State’s understanding of market readiness, scalability across diverse rural environments, feasibility of integration with commonly used Electronic Health Record (EHR) systems, and availability of cost-tiered options. This RFI is issued for market research and planning purposes only and does not constitute a commitment to procure services.

3.2 Background/Current State: The State of Missouri has secured federal funding to modernize its rural health infrastructure, expand access to care, and address long-standing health disparities through the Rural Health Transformation Program (RHTP). Missouri’s application emphasizes the adoption of advanced technologies, data-driven decision-making, and innovative care delivery models to promote high-quality healthcare for rural communities.

This initiative enables targeted investment and coordinates strategic planning to support transformation efforts including but not limited to the following objectives:

• Expanded access to care through the deployment of telehealth and Remote Patient Monitoring (RPM) solutions.

• Improve interoperability and data sharing across healthcare providers, state agencies, and community-based organizations.

• Enable evidence-based decision-making through the use of advanced analytics and performance measurement capabilities.

• Integrate a holistic approach to care delivery through the implementation of a social care referral platform.

https://ago.mo.gov/get-help/programs-services-from-a-z/sunshine-law/ https://ago.mo.gov/get-help/programs-services-from-a-z/sunshine-law/

Through the RHTP funding, the State of Missouri wants to make it easier for providers, especially those in rural communities, to use technology tools as part of their everyday clinical work. There have been rural providers that have expressed interest in using RPM and telehealth technology. The State is exploring ways to support access to and adoption of these tools to strengthen rural healthcare delivery and support the clinical workforce.

3.3 Future State: The State envisions a coordinated, statewide approach to expanding affordable and equitable access to RPM and telehealth solutions for rural providers. Under this model, the State would fund licensing costs for participating providers during an initial implementation period to accelerate adoption and reduce financial barriers to entry.

Following this State-supported period, providers would transition to assuming responsibility for ongoing licensing and subscription costs. This phased approach is intended to promote long-term sustainability by encouraging the adoption of solutions that demonstrate clear clinical, operational, and financial value.

4.0 Scope, Requirements and Data Integration Needs

4.1 Scope: The State of Missouri is seeking information from the vendor community on solutions and service models available to support two separate rural health technology initiatives. Each vendor response should address only one track. Vendors interested in both tracks must submit a separate response for each track.

4.1.1 Track 1: Remote Patient Monitoring for Maternal Care: The State is seeking information on Remote Patient Monitoring solutions that can strengthen maternal care in rural communities by extending clinical oversight between appointments, supporting earlier identification of emerging risks, and improving continuity of care throughout pregnancy and the postpartum period.

4.1.1.1 The proposed scope of this track includes:

a. Phased implementation of Remote Patient Monitoring solutions across rural maternal healthcare settings

b. Integration with existing EHR systems, care management platforms, and maternal care workflows

c. Connectivity with patient-owned or provider-supplied monitoring devices, as applicable; no device procurement is anticipated under this track

d. Configuration of maternal health monitoring protocols, clinical thresholds, alerts, and escalation pathways

e. Support for priority use cases, including hypertensive disorders of pregnancy, gestational diabetes, high-risk pregnancy monitoring, and postpartum care

f. Patient identification, enrollment, education, engagement, and ongoing technical assistance

g. Training and onboarding for clinical, administrative, and support staff

h. Ongoing platform maintenance, troubleshooting, technical support, and system updates

i. Compliance with applicable privacy, security, interoperability, and data governance requirements

j. Performance monitoring and reporting on patient enrollment, engagement, biometric readings, clinical alerts, interventions, utilization, and outcomes

k. Scalable pricing and operating models appropriate for rural and resource-constrained maternal healthcare providers

4.1.2 Track 2: Telehealth Specialist Access for Rural Hospitals and Providers: The State is seeking information on telehealth solutions and service models that can connect rural hospitals and providers with specialists, strengthen local clinical decision-making, expand access to specialty expertise, and reduce avoidable transfers to higher-acuity facilities. The State is seeking technology-enabled service offerings, subscription-based arrangements with specialist hospitals or health systems, and other models that provide participating hospitals with reliable access to specialty consultation and clinical support.

4.1.2.1 The proposed scope of this track includes:

a. Phased implementation of telehealth capabilities across participating providers, including Critical Access Hospitals

b. Subscription-based access to specialists through hospitals, health systems, or other qualified clinical partners

c. Access to qualified specialists for timely consultation, clinical guidance, and decision support

d. Integration with existing hospital systems, clinical workflows, and technology infrastructure

e. Provision, installation, configuration, and maintenance of telehealth equipment, including carts, workstations, tablets, and clinical peripheral devices, as applicable

f. Training and onboarding for hospital clinicians, specialists, administrators, and technical staff

g. Ongoing platform support, service coordination, licensing, equipment maintenance, troubleshooting, and system upgrades

h. Compliance with applicable privacy, security, credentialing, licensure, interoperability, and data governance requirements

i. Performance monitoring and reporting on consultation volume, specialist response times, patient disposition, transfer rates, avoided transfers, utilization, and provider experience

j. Scalable pricing and service models appropriate for rural hospitals and providers, with varying levels of clinical, financial, and technical capacity

4.2 Requirements: The proposed objectives/requirements for the service include, but are not limited to:

4.2.1 Mandatory Requirements:

a. Demonstrated integration with major EHRs and clinical systems using industry-standard interoperability protocols, including FHIR, HL7, APIs, or equivalent standards.

b. Compliance with HIPAA and applicable federal and state data privacy and security requirements.

c. Compliance with ADA (Americans with Disabilities Act) and Section 508 accessibility standards for any patient-facing or provider-facing software interfaces.

d. Secure data encryption (in transit and at rest) and defined data retention policies.

e. Ensure the State and participating providers retain full ownership of all clinical data. The solution must not use patient data or telehealth interactions to train, refine, or improve external algorithms or foundational models without explicit, opt-in consent and rigorous de-identification processes.

f. Maintain human oversight at the center of all clinical decision-making, ensuring provider validation of all RPM alerts and telehealth diagnoses.

g. Scalable deployment model suitable for rural hospitals, clinics, and small provider practices.

h. Implementation support, including providing a dedicated integration expert or project manager to guide the State in optimizing the tool's capabilities and integrating it across both clinical EHRs and other Departmental data systems.

i. Initial core provider and staff training.

j. Functions with limited or variable internet connectivity.

k. Requires minimal IT support after go-live.

4.2.2 Desirable Requirements:

a. Demonstrated experience implementing solutions in rural or resource-constrained settings.

b. Analytics and reporting capabilities to track program utilization, provider efficiency, service delivery, and clinical outcomes across RPM and telehealth.

c. Flexible pricing models that accommodate small or rural providers.

d. Support for non-physician providers.

e. Offline or near-offline functionalities.

4.3 Data Integration Needs: The proposed needs for data integration include, but are not limited to:

a. Level of EHR integration required (deep integration vs. lightweight overlay)

b. Time and resources required for integration

c. Impact of EHR version differences across rural sites

d. Whether the solution can operate in standalone mode if needed

e. Integration maturity and specific experience with the electronic health record (EHR) systems most commonly used by rural providers (e.g., Epic, Oracle Cerner, eClinicalWorks, Athenahealth, NextGen).

f. Availability of robust, secure APIs (e.g., RESTful APIs) or automated data export capabilities designed to feed structured data into non-EHR State systems, such as data warehouses and analytics platforms.

5.0 Questions for the Vendor

5.1 The list of questions is below. Respondents should copy the questions below into the response and provide the response immediately following each question.

5.2 Track 1: Remote Patient Monitoring for Maternal Care

5.2.1 Experience and Solution Overview

5.2.1.1 Describe your Remote Patient Monitoring solution, including its key capabilities and how it supports maternal care in rural communities.

5.2.1.2 Summarize your experience implementing RPM in rural, maternal health, or State-supported programs.

Include up to three relevant examples.

5.2.1.3 Describe how your solution has improved population health outcomes for enrolled patients. Please provide specific examples relevant to maternal or rural health, including metrics such as reduction in avoidable ED visits or hospitalizations, improvement in chronic condition control (e.g., hypertension, gestational diabetes), or improvement in quality measure performance (e.g., HEDIS, UDS, CMS eCQMs). Include baseline and post-implementation rates where available.

5.2.1.4 How many total patients are currently actively enrolled on your RPM platform? Please provide a breakdown by device type (e.g., blood pressure cuff, glucometer, pulse oximeter) and condition area where available.

5.2.2 Technical and Clinical Capabilities

5.2.2.1 Describe how your solution integrates with major EHR and care management systems, including supported interoperability standards such as HL7, FHIR, and APIs.

5.2.2.2 Describe the monitoring devices supported by your solution, including any partnerships with device manufacturers or distributors and how device integration, compatibility, connectivity, and technical support are managed. The State does not intend to purchase RPM devices under this track.

5.2.2.3 Describe the maternal health use cases supported, including clinical thresholds, alerts, and escalation workflows for conditions such as hypertensive disorders of pregnancy, gestational diabetes, and postpartum monitoring.

5.2.2.4 Describe how the solution performs in low-bandwidth or inconsistent-connectivity environments and identify the minimum technology requirements for participating providers and patients.

5.2.3 Implementation and Support

5.2.3.1 Outline your typical implementation approach and timeline, including workflow design, system integration, testing, and go-live.

5.2.3.2 Describe your approach to patient enrollment, education, engagement, and ongoing technical support.

5.2.3.3 Describe the training, workflow, billing and reimbursement support, and ongoing assistance provided to participating clinical, administrative, and technical staff, including guidance on documentation, coding, claims submission, and denial management, as applicable.

5.2.4 Pricing and Sustainability

5.2.4.1 Describe your pricing structure, including implementation, integration, licensing, support, and any per-patient, per-provider, or per-site costs.

5.2.4.2 Describe how your pricing model supports small rural providers and the continuation of services after the State-funded period.

5.2.4.3 Provide a Rough Order of Magnitude cost estimate for a maternal RPM program supporting 100 active patients across five rural provider sites. Exclude device costs and clearly state all assumptions.

5.2.5 Security and Compliance

5.2.5.1 Describe your approach to HIPAA compliance, accessibility, data security, data ownership, retention, audit logging, and applicable security certifications.

5.2.5.2 Describe whether patient or provider data is used to train or improve artificial intelligence models and any related consent, opt-out, segregation, or de-identification processes.

5.2.6 Reporting

5.2.6.1 Describe available reporting on patient enrollment, engagement, biometric readings, alerts, interventions, provider activity, and clinical outcomes.

5.2.6.2 Identify available dashboards, scheduled reports, data exports, and reporting levels, such as patient, provider, site, and program.

5.3 Track 2: Telehealth Specialist Access for Critical Access Hospitals and Providers

5.3.1 Organization and Experience

5.3.1.1 Provide an overview of your telehealth specialist-access model and the value it offers to small rural hospitals.

5.3.1.2 Describe your experience supporting rural hospitals, Critical Access Hospitals, or State-led telehealth programs. Include up to three relevant examples.

5.3.2 Specialist Access and Clinical Services

5.3.2.1 Identify the specialties available through your model, including coverage hours, consultation methods, typical response times, and service-level commitments.

5.3.2.2 Describe whether you can connect participating hospitals with specific Missouri-based specialists, hospitals, or health systems identified by the State or participating hospital.

5.3.3 Technology and Equipment

5.3.3.1 Describe how your solution integrates with hospital EHRs and clinical workflows, including its ability to operate in low-bandwidth or inconsistent-connectivity environments.

5.3.3.2 Describe your solution’s interoperability capabilities, including the clinical and administrative data exchanged, supported standards and interfaces, and how information is securely shared across participating hospitals and specialist providers.

5.3.3.3 Describe the telehealth equipment and clinical devices compatible with your solution, any established device vendor relationships, and the support provided for setup, integration, troubleshooting, and maintenance.

5.3.4 Implementation and Ongoing Support

5.3.4.1 Outline your typical implementation approach and timeline for a rural hospital, including site readiness, equipment deployment, integration, training, and go-live.

5.3.4.2 Describe the ongoing clinical, operational, and technical support provided after implementation.

5.3.4.3 Describe the training, workflow, billing and reimbursement support, and ongoing assistance provided to participating clinical, administrative, and technical staff, including support for telehealth documentation, coding, claims submission, specialist billing, and denial management, as applicable.

5.3.5 Pricing and Sustainability

5.3.5.1 Describe your pricing structure, including implementation, equipment, platform, specialist access, subscription, maintenance, and support costs.

5.3.5.2 Describe available subscription, bundled, regional, enterprise, or statewide pricing models and how they support long-term affordability.

5.3.5.3 Describe how your platform supports the billing and reimbursement of specialist services, including whether specialists bill the patient’s insurer directly, are compensated through the platform, or are paid by the participating hospital or another entity. Clarify whether specialist fees are included in the platform or subscription cost and identify any billing responsibilities expected of the State or participating providers.

5.3.5.4 Provide a Rough Order of Magnitude cost estimate for a 25-bed rural hospital requiring two telehealth carts, access to three specialties, and approximately 100 consultations annually. Separate one-time and ongoing costs and state all assumptions.

5.3.6 Security and Reporting

5.3.6.1 Describe your approach to HIPAA compliance, data security, data ownership, and applicable security certifications.

5.3.6.2 Describe available reporting on consultation volume, specialty utilization, response times, patient disposition, transfers, avoided transfers, and service performance.

6.0 Acronyms and Abbreviations

The following table defines the acronyms and abbreviations used throughout this Request for Information:

Acronym or Abbreviation Definition/Description

ADA Americans with Disabilities Act

AI Artificial Intelligence

APP Advanced Practice Provider

CAH Critical Access Hospital

CCBHO Certified Community Behavioral Health Organization

EHR Electronic Health Record

FHIR Fast Healthcare Interoperability Resources

FQHC Federally Qualified Health Center

HIPAA Health Insurance Portability and Accountability Act

HL7 Health Level 7

MHD MO HealthNet Division

RHTP Rural Health Transformation Program

ROM Rough Order of Magnitude

RPM Remote Patient Monitoring

RSMo Revised Statutes of Missouri

Appendix A – Vendor Response Cover Page

Respondent’s Name _________________________________________________________________________

Respondent’s Physical Address ______________________________________________________________

City_______________________ State_______ Zip Code (include 4 digit add on) ____________________

Respondent’s Contact Person _________________________________________________________________

Phone Number & Area Code ____________________________________

E-Mail Address ___________________________________________________

Website Address _________________________________________________

Authorized Signature of Respondent Date Signed

Typed Name and Title of Authorized Signatory