North Carolina Mobile Integrated Health and Community Paramedic Coalition

Why the 2026 CMMI Updates Will Change the Way You Partner with EMS 2026 CMMI Strategic Framework: Executive Summary The Center for Medicare and Medicaid Innovation (CMMI) has finalized the 2026 roadmap. The primary directive is the transition of all traditional Medicare beneficiaries into accountable care relationships by 2030. For healthcare systems, 2026 marks a critical pivot point. The focus shifts from episodic intervention to longitudinal management. Emergency Medical Services (EMS) and Mobile Integrated Healthcare (MIH) are no longer peripheral transport services. They are now essential components of the value-based care (VBC) continuum. The AHEAD Model: Statewide Impact and EMS Integration The All-Payer Health Equity Approaches and Development (AHEAD) model commences its primary implementation phase in 2026. This model utilizes prospective primary care payments and hospital global budgets. Global Budgets and Cost Avoidance Under global budgets, hospital revenue is fixed....

How to Integrate 988 Crisis Response With Your Existing 911 Dispatch System Overview: 911 and 988 Interoperability The integration of the 988 Suicide & Crisis Lifeline with existing 911 Public Safety Answering Points (PSAPs) is a primary objective for EMS Systems Improvement. The current objective is to divert non-emergent behavioral health calls from law enforcement and Emergency Medical Services (EMS) to appropriate mental health resources. Technical and operational synchronization between these two distinct systems is required for public safety consulting efficiency. The North Carolina Mobile Integrated Health and Community Paramedic Coalition identifies this integration as a critical component of state-level healthcare infrastructure. Technical Architecture and Infrastructure Requirements System interoperability depends on the alignment of telephony and data transfer protocols. 2.1 Telephony Integration Primary PSAPs must establish dedicated transfer lines to 988 call c...

How to Integrate Community Paramedicine with Primary Care and Behavioral Health Mobile Integrated Healthcare (MIH) and Community Paramedicine (CP) represent a fundamental shift in emergency medical services. The North Carolina Mobile Integrated Health and Community Paramedic Coalition advocates for the transition from a traditional reactive transport model to a proactive, value-based healthcare delivery system. Successful health care system integration requires technical precision, clinical alignment, and robust administrative frameworks between EMS providers, primary care networks, and behavioral health specialists. Core Framework for MIH System Integration Effective integration depends on the alignment of clinical goals and operational capabilities. EMS Systems Improvement initiatives must focus on bridging the gap between acute pre-hospital response and long-term longitudinal care. The North Carolina Mobile Integrated Health and Community Paramedic Coalition identifies four crit...

7 Mistakes You’re Making with MIH Workforce Integration (and How to Fix Them) 01. Role Scope Ambiguity Error: Undefined Practitioner Parameters Mobile Integrated Healthcare (MIH) initiatives frequently collapse due to the absence of defined clinical boundaries. EMS leaders often deploy paramedics into MIH roles without modifying Job Description (JD) protocols. This results in "scope creep" where practitioners operate in a legal grey area between emergency response and primary care. Data Point: Operational Friction 42% of pilot programs report role confusion between Community Paramedics (CPs) and Home Health Nurses. Overlapping responsibilities lead to redundant billing and decreased clinician morale. Corrective Protocol Differentiate Protocols : Establish distinct Standing Orders for MIH vs. 911 response. Standardize JDs : Document specific MIH competencies including chronic disease management and social determinants of health (SDOH) assessment. Legal Review : V...

Across the United States, EMS systems are searching for sustainable ways to expand Mobile Integrated Healthcare (MIH) and Community Paramedicine (CP). While pilot programs are growing across North Carolina and the Southeast, one of the most developed examples of community paramedicine can be found north of the border in Ontario, Canada. Ontario’s Community Paramedicine programs have evolved over more than a decade into a coordinated system that integrates paramedics with public health, primary care, social services, and hospital systems. For those of us working on community paramedicine collaborations in North Carolina, the Ontario model offers valuable lessons in structure, data use, and system integration. A System Designed Around Prevention Traditional EMS systems were built to respond to emergencies. Community paramedicine flips that model by allowing paramedics to intervene earlier in the cycle of illness and social vulnerability. Ontario’s programs focus on several key popula...