Implementing and Sustaining Rural Community Paramedicine

National Rural Health Center
Tami Lichtenberg
Implementation Tool
June 2021
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This report offers key strategies to support the implementation and sustainability of mobile integrated health and community paramedicine (MIH-CP) programs in rural communities.


MIH-CP programs are innovative care models that expand the role of paramedics and emergency medical technicians, enabling them to provide a broader range of nonemergency home- and community-based services. These programs can play an important role in increasing access to primary, preventive, and follow-up care services; improving health outcomes; and reducing preventable acute care utilization. In particular, MIH-CP programs offer opportunities to reduce disparities in access to care often experienced in rural communities.

This report was developed following the 2021 Rural Community Paramedicine Summit, convened by the National Rural Health Resource Center. At the summit, MIH-CP providers and relevant stakeholders discussed key strategies, challenges, and opportunities associated with the implementation and sustainability of MIH-CP programs in rural communities.


Developing community partnerships, initiating MIH-CP programs with a narrow focus, using data to demonstrate value, and ensuring patient awareness are emphasized in the report as key implementation strategies. The potential for MIH-CP models to expand their scope to encompass care coordination or care management services is also highlighted. Partnerships with accountable care organizations, participation in Centers for Medicare & Medicaid Services models, and engaging with the federal Flex Grant Program, are featured as promising funding opportunities.   


This report reflects the dynamic nature of MIH-CP programs. While best practices in models of care and financial sustainability are rapidly evolving, insights from the 2021 summit offer a valuable reference point for stakeholders seeking to implement MIH-CP programs in their community. The report’s recommendations on fostering partnerships and accessing federal funding to ensure financial sustainability are especially relevant following the conclusion of temporary pandemic-related federal policies that permitted Medicare reimbursement of emergency medical services staff for providing treatment in place.

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