Ready to get started?
Start nowChallenge
- Legacy Citrix and on-premises RDS environments were becoming fragile and difficult to maintain
- Managing remote access securely for a distributed workforce handling sensitive healthcare data introduced risk
- Native Azure Virtual Desktop was too complex for a team of IT generalists to deploy and manage effectively
Solution
Migrated to Azure Virtual Desktop managed through Nerdio Manager for Enterprise to simplify deployment and ongoing management
Integrated remote desktop environments into a Zero Trust security architecture with conditional access controls
Enabled scalable, cloud-native remote access to support both field workers and business continuity scenarios
Supporting healthcare access across a distributed state
The Mississippi Division of Medicaid provides healthcare coverage to vulnerable populations across the state, supporting a wide network of providers, outreach workers, and regional offices.
With operations spanning rural communities and more than 30 offices, the organization must ensure that staff can securely access systems, whether they are in the office, in the field, or responding to unexpected disruptions.
“We’ve got outreach workers going into nursing homes and communities across the state,” said Brad Estess, CTO of the Mississippi Division of Medicaid. “And we also have situations—like freezes or tornadoes—where multiple offices may be closed at once.”
To support both day-to-day operations and these edge cases, the agency relied on a mix of Citrix and on-premises Remote Desktop Services (RDS). Over time, that approach began to show its limits.
“The solution worked well enough at the time, but it had started to get fragile,” Estess explained. “And strategically, we were trying to get out of the data center business and move to cloud-native solutions.”
Balancing security with accessibility
Security is central to everything the organization does. As a healthcare payer, the agency manages large volumes of protected health information (PHI), making secure access non-negotiable.
“We handle a lot of protected information, so security is at the forefront of what we do,” Estess said. “There’s a lot of HIPAA risk associated with our environment.”
At the same time, the legacy environment was facing ongoing pressure.
“We were seeing ongoing credential spray activity against the legacy system,” he explained. “That was a risk, and we knew we needed to move away from that model.”
The team evaluated Azure Virtual Desktop as part of its cloud strategy, but quickly encountered another challenge.
“It seemed cumbersome to manage, and it wasn’t a great fit for our staff,” Estess said. “We have a lot of IT generalists, and we needed something they could realistically operate.”
Simplifying AVD for real-world IT teams
Nerdio Manager for Enterprise provided the missing layer that made Azure Virtual Desktop viable.
After evaluating the platform, the team saw that it could simplify deployment, reduce management overhead, and make the solution accessible to their existing staff.
“The additional features and management capabilities made it a much better fit for us,” Estess said. “It made the whole remote compute environment easier to manage.”
That simplicity was critical in a public sector environment where hiring highly specialized cloud engineers is not always feasible.
“Staffing is a challenge for state agencies,” he explained. “We don’t pay private sector salaries, so having something that lowers the burden on training and makes it easier to cross-train staff is extremely valuable.”
Enabling secure, Zero Trust remote access
With Nerdio-managed AVD in place, the agency was able to wrap its remote desktop environment in a broader Zero Trust security framework.
“What AVD and Nerdio allow us to do is integrate with our Zero Trust stack,” Estess said. “We can apply conditional access policies, ensure users are on compliant devices, and control who gets access under what conditions.”
This approach significantly reduces risk while still enabling flexible access for staff.
For an organization handling sensitive healthcare data, that balance between accessibility and control is critical.
Supporting continuity during real-world disruptions
Beyond security, the platform has proven essential for maintaining operations during unexpected events.
“We had a freeze this past winter where seven or eight offices were closed,” Estess said. “This gives those teams a way to continue working.”
Instead of shutting down operations, employees can securely access systems remotely and continue serving constituents.
That capability has become a core part of the agency’s resilience strategy.
Shifting focus from infrastructure to service delivery
One of the most meaningful outcomes has been a shift in how the IT team spends its time.
“We get to focus more on service delivery and less on managing infrastructure,” Estess said.
For a public sector organization, that shift represents a significant improvement in how IT delivers value to the business.
Rather than maintaining fragile systems, the team can focus on enabling services that directly support healthcare delivery.
A long-term solution for a critical need
After a successful deployment and renewal, the Mississippi Division of Medicaid now views Nerdio Manager as its long-term platform for remote computing.
“We feel good about it from a security standpoint, from a functionality standpoint, and from a management overhead standpoint,” Estess said. “It’s a solved problem for us.”
For the agency, the outcome is less about excitement and more about confidence: a secure, scalable solution that meets critical business needs and allows the organization to move forward.
Read the full customer story
See how Mississippi Division of Medicaid strengthened security and simplified remote access with Nerdio