From Good Work to Funded Work:
How MIH Programs Prove Their Value

The Shift from Funding Opportunity to Accountability Model

Mobile Integrated Healthcare programs are no strangers to delivering meaningful care: every day, community paramedics prevent crises, support patients at home, close care gaps, and address the non-medical factors that so often drive unnecessary utilization. However, as MIH leader Jamie Wilson emphasized during a recent national MIH conference, doing great work is only one piece of the equation.

Jamie Wilson (MBA, BSN, RN, EMT-P) has helped develop collaborative care models with managed care organizations, ACOs, and health systems across multiple states. Using that real-world experience, he shared a message both strategic and actionable: to build sustainable programs, MIH leaders must learn their teams’ true value, and communicate it in a way that payers understand.

Two Perspectives: Worth and Value

One of the most important ideas Jamie put forward was the distinction between worth and value.

Many MIH programs are highly effective, yet still struggle to secure sustainable reimbursement. They provide high-quality care, and their community greatly benefits, but their partnerships and contracts still fall through. The problem is that their the impact, while great, is lost in translation. Everyone understands the team’s worth, but the payers and health systems don’t understand the team’s value.

Worth is the expertise MIH teams bring into the field. It is the clinical judgment, the home-based assessment, the medication review, the patient education, the gap-closing, and the trust that community-based clinicians build over time. An MIH team’s worth is what gains them respect; what gets them in the door for negotiating partnerships and contracts.

Value is different. It is what partners can measure, what they use in their own problem-solving. It is reduced unnecessary utilization. It is improved chronic disease management. It is fewer avoidable transports, fewer preventable readmissions, better care coordination, and a more efficient use of healthcare resources. An MIH team’s value is what seals the deal on their partnerships and contracts.

Value: the Language of Payers and Health System Partners

A few common, measurable values in MIH include:

• number of unnecessary 911 calls, ambulance transports and ED visits
• number of hospital admissions and readmissions
• number of clinical quality gaps closed (measured with a standard system, such as HEDIS)
• average treatment compliance among a patient population
• various clinical longitudinal outcomes (such as lowered A1C results in diabetic patients)

These value measures are familiar. In his presentation, Jamie made two points that may be less familiar, but that are crucial for communication with payers and partners.

First, nearly all measurable values relate to cost. While each payer and health system will have their own priorities, cost will always be a factor. For values like ambulance transports and hospital admissions, the cost is obvious, but even raising average treatment compliance relates to cost, since the more patients accurately follow their treatment plans, the less prone they’ll be to emergencies and readmissions. If an MIH team can present their work alongside a list of costs reduced, they’ll have a much stronger position.

Second, it’s important to establish that your team is causing these values to change. On a case-by-case basis this is fairly straightforward, especially if you’re working with referrals; it’s on the scale of a county or state that things get challenging. Significant change is measured over months and years, and it’s important to use value measures with a long history – though these are often hard to find. An important resource are the payers and partners themselves: they’ll know their own costs, and may have data from past years that you can compare with your current results.

Establishing a Scope of Work: Collaboration is Key

A major takeaway from Jamie’s presentation was that communicating your team’s value is much, much easier when you collaborate with your payers or partners from the start, establishing a clear scope of work.

The first things to establish are what value measures your partners want to see. This is familiar territory for MIH teams that work with grant requirements, but it’s necessary for any partnership. Accurately reporting value measures for your work, including related cost reductions, can take a lot of effort; if the values aren’t ones your partners care about, all the effort is wasted.

It’s also important to understand the terminology your partners use. Different health systems may use different terms to describe the same work; even working with a single partner, the terminology may change over the years. Depending on the partner, even the term “patient” may change to something like “member”. Keeping your terms consistent keeps results from getting lost, and negotiations are much easier when you literally speak your partner’s language.

Jamie also emphasized that knowing your team’s value helps you avoid under-valuing them. While collaboration should be the priority, knowing that your service will significantly reduce your partner’s costs can give you the leverage to ask for the budget you need.

A Timely Message for MIH Leaders: Success in RHT

The question of how to move from “promising” to “funded” is a timeless one, but Jamie Wilson’s message feels especially timely now with the increase in both available funding and reporting requirements.

Over the next five fiscal years, the Rural Health Transformation program (RHT) is set to provide $50 billion in funding for state initiatives to improve patient health outcomes, and all 50 states have been approved for some level of funding. The goals of the program closely align with MIH practices, including an emphasis on prevention, chronic disease management, substance use disorder treatment, mental health services, and technology driven solutions such as remote monitoring. The next five years hold great promise for rural healthcare in general, and rural MIH programs in particular.

However, the stakes are high for RHT reporting. The Centers for Medicare & Medicaid Services will periodically reassess a state’s progress, and will adjust funding based on certain checkpoints and policy commitments. If a state and its partners cannot show the value they’ve achieved, the funding may be reduced or cut off. In some circumstances, funding will be recovered.

For MIH leaders, their teams and their partners, the takeaway is clear: success in RHT will belong to those that can deliver exceptional care while also communicating the value of that care, in clear, consistent reports.

The Path Forward

MIH teams already know the worth of their work. The next step is to learn its value, and to learn how to communicate that value to payers, health systems and other partners.

That means aligning with your partner’s priorities. Speaking their language. Keeping clear records of measurable values. Understanding how much your work reduces costs for your partners, and understanding the value of what your team brings to the table.

Jamie’s presentation was a strong reminder that the goal is not simply to provide worthwhile care: it’s also to prove the value of that care, in terms that are clear, measurable, and undeniable.

Jamie Wilson is an innovator in Mobile Integrated Healthcare. He has combined his EMS career of 25+ years with his Nursing career of 13+ years to develop a creative innovative approach to closing healthcare gaps. Through creation and execution of multiple Mobile Integrated Healthcare programs, he has developed best practice last mile care delivery programs that close gaps in care leading to innovative models while improving care delivery and patient outcomes. Having perspective as a Registered Nurse, Paramedic, and through leading business initiatives, Jamie has developed proprietary models of collaboration with MCOs, ACOs, and health systems across multiple states.

Source: Jamie Wilson, MBA, BSN, RN, EMT-P, “You’re Worth It: Know Your Worth, Show Your Worth, Get Paid Your Worth,” presentation at the 2026 NAMIHP MIH Summit, Scottsdale, AZ, March 24, 2026.

Frequently Asked Questions

What is the difference between worth and value in MIH programs?

In MIH, worth refers to the clinical expertise and quality care that community paramedics deliver in the field. Value is how that care translates into measurable outcomes that payers and health systems can track, such as reduced ED visits, fewer hospital readmissions, and lower overall costs.

What metrics do payers use to measure MIH program value?

Common value measures include reductions in unnecessary 911 calls, ambulance transports, ED visits, hospital admissions and readmissions, the number of clinical quality gaps closed (often tracked via HEDIS), treatment compliance rates, and longitudinal clinical outcomes such as improved A1C levels in diabetic patients.

How can MIH programs secure sustainable reimbursement?

Sustainable reimbursement depends on communicating measurable value in terms that payers understand, specifically cost reductions tied to your program’s outcomes. Collaborating with partners early to define a clear scope of work, agreeing on which metrics matter, and keeping consistent terminology all strengthen your position during contract negotiations.

Why is collaboration with payers important when establishing an MIH scope of work?

Different payers prioritize different outcomes and may use different terminology for the same services. Aligning on value measures and language from the start ensures your reporting reflects what your partners actually need to see, saving time and keeping negotiations on track.

What is the Rural Health Transformation (RHT) program, and how does it affect MIH funding?

The Rural Health Transformation program is a federal initiative providing $50 billion over five fiscal years to support state efforts to improve patient health outcomes, with all 50 states approved for funding. Its goals align closely with MIH priorities, including prevention, chronic disease management, mental health, and remote monitoring. However, CMS will periodically reassess progress, and funding can be reduced or recovered if states and their partners cannot demonstrate measurable results.

How can MIH leaders avoid undervaluing their programs in partnership negotiations?

Understanding the full cost-reduction impact of your services gives you leverage at the negotiating table. When you can demonstrate with data how much your program saves a partner in avoidable utilization and care costs, you are in a much stronger position to ask for the budget your team actually needs.