Changes in the U.S. health care system are providing opportunities for emergency medical service agencies to enter public and private partnerships and provide innovative community health services. Local government examples of how three different types of EMS systems have implemented integrated health care programs are part of the June Public Management (PM) cover story “EMS in the Era of Health Care Reform.”

The examples of how EMS systems are adjusting to the changing health care environment offer these insights:

1. Changes in health care financing will impact EMS. Already, it is clear that changes in how the Centers for Medicare and Medicaid Services reimburses hospitals have had significant impacts on the health care system. It has made no secret of the fact that it wants less fee-for-service and more value-based purchasing.

2. EMS must develop relationships with other health care partners. No longer can an EMS agency see itself as independent from the rest of the health care system. Successful community paramedic and mobile integrated health care programs rely on public-private partnerships with hospitals, physicians, payers, and other members of the health care community.

3. Not all mobile integrated health care (MIH) programs should look the same. Since the passage of the Affordable Care Act, EMS agencies across the country have rushed to start MIH programs. While some have been successful, their long-term sustainability is still unclear. Each community should conduct an assessment to determine its needs, available resources, and what role EMS can play in improving the health of the community.

4. Not every EMS call needs the same response. What mobile integrated health care programs are doing is recognizing that EMS providers can provide (and patients require) services other than immediate transport to an emergency room. In order to truly serve the community, both by providing patient-centered care and fiscally responsible service, leaders should examine whether the services they currently provide match the demands and expectations of those they serve.

For details on the three local government examples, read “EMS in the Era of Health Care Reform.” For an in-depth look at the future of EMS in the era of health care reform, see information provided on ICMA’s 2015 Infocus report “The New EMS Imperative: Demonstrating Value.”