The Economics of Care: Why Physicians Must Engage in Reimbursement with Dr. Nicholas Cozzi

Healthcare systems are being reshaped by innovation, policy pressure, and financial reform, but one of the most overlooked drivers of change is how care is actually paid for. In this episode of The Leadership Lab with Asbel Montes, Dr. Nicholas Cozzi—emergency physician and EMS Medical Director—explores a foundational tension in healthcare finance: a reimbursement model that continues to prioritize transport over care delivered. Even as EMS evolves into mobile integrated healthcare and value-based care frameworks expand, reimbursement structures often fail to reflect clinical reality. Patients are assessed, stabilized, and treated in real time outside the hospital. Yet without transport, that work frequently goes unpaid. Through a powerful clinical scenario involving a severe asthma patient treated at home with advanced interventions and physician oversight, Dr. Cozzi highlights a stark contrast: the same level of care that would be billable in the emergency department is not recognized within EMS payment systems. This disconnect raises a broader systems question for healthcare leaders: How do we define value in a system where care is increasingly delivered outside traditional settings? The episode also reframes EMS not as a standalone service, but as part of a continuous care ecosystem that spans the home, the field, and the hospital. Yet current financial systems continue to treat these stages as separate rather than interconnected. For healthcare executives, finance leaders, policymakers, and EMS professionals, this episode surfaces critical questions about alignment, accountability, and the future of healthcare funding. This episode dives into: Why EMS reimbursement remains tied to transport instead of clinical care value How high-acuity prehospital care is often uncompensated under current models Why physician engagement in healthcare finance is becoming essential How the gap in healthcare economics education impacts system-level decisions Why the shift from "fair" to measurable reimbursement matters for reform How mobile emergency medicine is reshaping acute care delivery Why EMS and ED systems must be viewed as one continuous care pathway For healthcare leaders, the implications are clear: reimbursement design is not just a financial mechanism, it is a behavioral force that shapes how care is delivered, documented, and ultimately valued. And as healthcare continues to move beyond hospital walls, the systems that fail to evolve will increasingly fall out of alignment with the care patients are already receiving. 🔔 Subscribe to The Leadership Lab with Asbel Montes and join the conversation about what's next for healthcare leadership.   Links: Asbel Montes LinkedIn - https://www.linkedin.com/in/asbel-montes-31027634 Dr. Nicholas Cozzi LinkedIn - https://www.linkedin.com/in/nicholaspcozzi/    Solutions Group Services: LinkedIn - https://www.linkedin.com/company/solutionsgroupservices  Instagram - https://www.instagram.com/solution_sgroup/  Facebook - https://www.facebook.com/solutionsgroupservices  Website -  ​​https://www.solutionsgroup.com/