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What if the biggest risk to healthcare system stability isn’t funding shortages or federal delay, but EMS being excluded from the decisions that shape care delivery? In this episode of The Leadership Lab, Asbel Montes sits down with New Hampshire State Senator Sue, a former paramedic, State EMS Director, and national trauma leader, for a candid conversation on leadership, rural healthcare policy, and why EMS must be treated as essential healthcare infrastructure. Blending frontline experience, state-level policymaking, and systems thinking, this discussion challenges long-held assumptions about reimbursement, access, and who gets a voice in healthcare reform. At a time when healthcare finance leaders are under pressure to stabilize rural access, control costs, and deliver measurable outcomes quickly, this conversation surfaces a tension few are willing to name: EMS carries growing responsibility, without proportional representation or financial protection. How do healthcare systems become more efficient, more resilient, and more patient-centered if EMS remains on the margins of policy? Whether you’re a healthcare finance executive, system leader, policymaker, or EMS executive, this episode invites you to rethink not just how EMS operates—but how healthcare systems are designed. What You’ll Learn in This Episode: ✅ EMS as Core Infrastructure Why EMS sits at the intersection of healthcare, public health, and safety—and what breaks when it’s excluded. ✅ From Paramedic to Policymaker How lived EMS experience reshapes smarter, faster healthcare policy at the state level. ✅ Direct Pay & Treat-No-Transport Reform How targeted reimbursement changes stabilized EMS agencies without waiting for federal action. ✅ Rural Health Stabilization in Practice What the $204M fund reveals about speed, accountability, and system coordination. ✅ Ground Ambulance Billing & Patient Protection Why removing patients from billing disputes requires state leadership, not just federal rules. Key Takeaways for Healthcare Leaders: EMS is healthcare infrastructure, not an add-on. State policy can deliver faster, more durable wins than federal reform. Unified leadership matters more than perfect policy. Sustainable systems are built where EMS has a permanent seat at the table. If this conversation reframed how you think about healthcare systems and leadership, share this episode with a leader shaping policy, finance, or care delivery. Because healthcare systems don’t fail in theory, they fail where infrastructure is ignored. 🔔 Subscribe and turn on notifications to never miss a conversation that challenges conventional thinking and equips you to lead transformational change. 💬 Share your thoughts: How is your organization fostering a culture of candor and innovation, and what barriers are you facing as you try to implement it? Links: Asbel Montes LinkedIn - / asbel-montes-31027634 Sue Prentiss Facebook - / sueprentissfornh Sue Prentiss LinkedIn - / suzanne-prentiss-961414a4 Sue Prentiss Instagram - / sueprentissfornh Sue Prentiss X - https://x.com/PrentissSuzanne Solutions Group Services: LinkedIn - / solutionsgroupservices Instagram - / solution_sgroup Facebook - / solutionsgroupservices Website - https://www.solutionsgroup.com/