As EMS|MC celebrates 20 years of EMSpire events, this year marked a milestone with the inaugural EMSpire West in Pasadena, CA. Kicking off this landmark year on the West Coast, the event brought together EMS leaders from across the country at a time when the industry is evolving faster than ever.
This year’s theme, Build the EMS Agency of 2026: Strong People, Smarter Decisions, Sustainable Revenue, reflects the reality agencies are facing today. EMS is being asked to do more with less, while navigating increasing reimbursement pressure and operational challenges. The path forward requires more than adaptability.
As EMS|MC Chief Customer Officer Jason Brantley emphasized, “EMS remains a critical yet often underserved part of the healthcare system. Its strength lies in its direct connection to the patient, but its future depends on building organizations that are operationally sound, financially resilient, and people focused.”
Where the Mission Meets the Medic: Why Organizational Health in Foundational to a People-First Model
Carrie Williams, EMS|MC Chief People Officer, led a powerful session on what it truly means to build a people-first EMS organization. Centered on the four disciplines of organizational health: building a cohesive leadership team, creating and reinforcing clarity, and over-communicating daily. Her message emphasized that strong culture creates a firm foundation for the agency. Backed by 62 healthcare studies linking positive organizational culture to improved patient outcomes, the session emphasized how an agency operates internally directly impacts the care delivered in the field.
“All organizations know how to hire people, and how to balance their budgets. But not every organization knows how to focus on organizational health,” she stressed. “[Leaders] create clarity for employees, for them to feel safe and explore the organization. And [leaders] really have an impact on employees’ entire experience there. And when they create organizational health within the company, they reduce turnover.”
From Narrative to Net Revenue: AI in EMS Documentation and Revenue Cycle
PWW|AG EMS & Mobile Healthcare Consultant Dr. Shannon Gollnick’s session, From Narrative to Net Revenue, reframed documentation as the financial engine of EMS. Every patient encounter produces both a clinical and financial outcome, and both are determined at the point of documentation.
He highlighted a critical gap: while documentation drives reimbursement, many clinicians don’t view it as a top priority, leading to missed revenue opportunities. “Everything that we do revolves around reimbursement of that ePCR., That one document is the sole source of our revenue, but only 58% of the clinicians defined that it is extremely important,” Dr. Gollnick explained. “It is extremely important. There’s a gap somewhere between what paramedics are required to do as clinicians and what we need them to do as EMS leaders.”
At the same time, AI is rapidly reshaping the landscape, from narrative generation to real-time coding and denial prediction, making it the new baseline.”
Public Provider Reimbursement Strategies: Turning Compliance into Sustainable Revenue
“Demand drives your deployment, deployment drives your cost of service, cost of service drives your rates, and rates ultimately determine reimbursement.” It may sound like an oversimplification, but AP Triton Co-Founder Scott Clough used this framework to ground his session on Public Provider Reimbursement Strategies, emphasizing the importance of viewing EMS as a business while keeping high-quality patient care at the center of operations.
Clough took a practical, numbers-driven approach, showing how everyday operational decisions directly impact financial performance. Rather than focusing only on large-scale solutions, he highlighted the importance of capturing overlooked revenue opportunities, particularly through stronger documentation practices, where small gaps can lead to significant lost revenue.
Protecting the Dollar: Reimbursement, Risk & Readiness in Today’s EMS Landscape
Kim Stanley, EMS|MC Chief Client Advocacy Officer, delivered a data-driven look at Protecting the Dollar: Reimbursement, Risk & Readiness in Today’s EMS Landscape, leveraging insights from more than 6 million annual ambulance trips to highlight key financial trends shaping the industry.
Her session emphasized a critical connection: what agencies charge, bill, and document directly impacts what they are ultimately reimbursed. As she explained, only 9.5% of agencies are currently billing for treatment in place, making it difficult to advocate for broader Medicare reimbursement. She stressed that from the viewpoint of CMS, “if less than 10% of agencies are billing for it, it must not be very important.”. This is the challenge of pushing coverage when the industry itself isn’t consistently capturing the service.
She also reinforced the growing need for audit readiness, as payers increasingly challenge claims using evolving and sometimes inconsistent standards, making compliance and documentation more important than ever.
The Business of EMS Leadership
The panel discussion on The Business of EMS Leadership brought together leaders from across fire-based paramedics, EMS, healthcare, and advocacy to explore how the role of EMS is rapidly evolving beyond traditional response models.
A central theme was the shift toward integrated care. Panelists highlighted how Mobile Integrated Healthcare (MIH) and similar programs are bridging the gap between pre-hospital care and the broader healthcare system, focusing on delivering the right care, at the right time, in the right setting.
EMS Division Chief for the City of Beverly Hills Sean Stoke explained that their MIH model has resulted in, “better communication with patients. Whether it’s going to hospital or homes and making sure patients are complying with their prescribed care and understand their health care.
These models not only improve patient outcomes, but also reduce unnecessary transports and system strain.
Equally important – the role of collaboration. Whether working with health systems, insurers, or community partners, the panel highlighting why EMS cannot operate in isolation. Sacramento Metro Fire Battalion Chief Scott Perryman stressed the need to look beyond a purely fire-based perspective, noting, “We need different visions and viewpoints, not just a 100% fire lens. EMS leaders must be able to see through multiple lenses and become stronger advocates for that approach.”
Success in this next phase of EMS will depend on strong partnerships, data-driven decision-making, and a willingness to adopt new care models that better align with the future of healthcare.
As Jason Brantley shared in closing, the impact of this work goes far beyond revenue. The dollars captured and protected today translate directly into stronger agencies tomorrow, better equipment, improved readiness, and the ability to support and retain the people behind the mission.
At its core, it’s about ensuring EMS agencies are prepared when it matters most. Because when the call comes in, readiness isn’t optional, it’s everything.
That’s what drives EMS|MC. And every day, our mission remains the same: to help first responders answer the call.