MIH / Community Paramedicine POCUS Value & ROI Calculator

Estimate the potential incremental economic and operational value of adding point-of-care ultrasound to an existing Mobile Integrated Health (MIH) or community-paramedicine program. The calculator opens with a conservative POCUS contribution scenario and allows every utilization and cost assumption to be replaced with program-specific data.

Conservative POCUS contribution scenario 2026 U.S. acute-care cost benchmarks Local assumptions fully editable

1. MIH volume

Estimate POCUS-eligible encounters from annual MIH visits, or enter the known eligible volume directly.

Illustrative program volume only; replace with local data.
Illustrative planning assumption, not a published prevalence estimate.
Reduce for partial adoption, device availability, staffing, or protocol limitations.

2. Baseline disposition & conservative POCUS contribution

The published MIH transport benchmark is 28.6%. The default calculator scenario assumes POCUS reduces that baseline ED referral volume by a conservative 10% relative amount among POCUS-eligible encounters—equivalent to 2.86 fewer ED referrals per 100 eligible visits at the default baseline. This is a planning assumption, not a published ultrasound-only effect.

Published MIH reference from Xie et al.; local program disposition data are preferred.
Default: 10% conservative planning scenario. This is not a published POCUS-specific effect and should be replaced with local implementation data when available.
Clinical-safety outcome only. It is displayed but not treated as a financial failure.
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Default $2,715: 2026 U.S. ED comparison-cost benchmark. For whole-pathway analyses, use the net MIH comparison presets below.
Default 0. Add only when direct POCUS attribution is defensible; avoid double counting with ED avoidance.
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2026 U.S. reference benchmark. Excluded from the base scenario until a nonzero documented count is entered.
Clinical safety remains separate from savings: a POCUS finding that appropriately sends a patient to the ED can represent clinical value even though utilization increases. Appropriate escalations are therefore reported separately and are not subtracted from ROI.

3. POCUS time & capacity assumptions

Treat added clinician time as capacity consumption unless it creates an actual incremental labor expense.

Conservative planning assumption. Replace with measured MIH workflow time.
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Local loaded labor/capacity value preferred. Default $0 to avoid overstating economics.

4. Program investment

Enter the incremental cost of adding POCUS to MIH—not the cost of the entire MIH program.

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Leave at $0 if suitable equipment already exists.
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Include only incremental cost attributable to the POCUS program.
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Methodology & evidence

Published MIH evidence supports the economic mechanism, but current evidence does not justify assigning the entire MIH benefit to ultrasound.

MIH transport and cost mechanism
Baseline ED referrals = Addressable POCUS-eligible MIH visits × baseline ED referral rate
Avoided ED episodes = Baseline ED referrals × POCUS-attributable reduction
Xie F, Yan J, Agarwal G, Ferron R. Economic Analysis of Mobile Integrated Health Care Delivered by Emergency Medical Services Paramedic Teams. JAMA Netw Open. 2021;4(2):e210055. doi:10.1001/jamanetworkopen.2021.0055. In the Canadian MIH cohort, 28.6% of MIH calls required ED transport versus 74.7% of matched ambulance calls; this demonstrates the MIH mechanism but not an incremental POCUS effect. Full textModerate / indirect
U.S. acute-care cost benchmarks
ED cost avoidance = Avoided ED episodes × value per ED episode
Admission cost avoidance = Documented POCUS-attributable avoided admissions × value per admission
O'Connor L, Dunn O, Merolle S, et al. A Cost Analysis of Mobile Integrated Health for Acute Care. West J Emerg Med. 2026;27(2):445-451. doi:10.5811/westjem.48521. Median modeled MIH cost was $550 for a basic call and $1,400 for an advanced call; the study cited mean comparison costs of $2,715 for an ED visit and $24,680 for an inpatient admission. Single-system simulation-based estimates; local costs preferred. PubMedModerate benchmark
Why the default POCUS contribution scenario uses 10%

There is not yet a portable published percentage showing how much ultrasound alone reduces ED referral in MIH. The calculator therefore uses a deliberately modest 10% relative reduction in baseline ED referrals as a transparent planning scenario. At the published 28.6% MIH transport benchmark, this represents an absolute effect of 2.86 avoided ED referrals per 100 POCUS-eligible visits. The assumption is intentionally far below reductions reported for some broader community-paramedicine programs, while recognizing that a 2026 randomized trial of a broader CP intervention found no significant reduction in acute-care utilization. The 10% value is therefore a scenario—not a clinical guarantee—and can be switched to 0% or replaced with local POCUS data.

Burnett A, Wewerka S, Miller P, et al. Community Paramedicine Intervention Reduces Hospital Readmission and Emergency Department Utilization for Patients with Cardiopulmonary Conditions. West J Emerg Med. 2023;24(4):786-792. The matched observational CP cohort had 40.7% fewer total ED visits; this was a whole-program effect and is not attributed to POCUS here. Full text

McCoy RG, Juntunen MB, Ridgeway JL, et al. Effect of an Advanced Community Paramedic Program to Shorten or Prevent Hospitalizations: A Pragmatic, Point-of-Care, Randomized Clinical Trial. Ann Fam Med. 2026;24(2):131-139. Full textConservative scenario assumption
Community-paramedic POCUS proof of concept

Balasubramanian S, DeFilippo M, Stone M, et al. Pneumothorax Identified by a Remote Physician Using Paramedic-obtained Tele-ultrasound: Case Report. Clin Pract Cases Emerg Med. 2024;8(3):189-193. This illustrates that POCUS can also appropriately increase escalation when dangerous pathology is identified; it does not provide a population-level effect size. PubMed

Proof of concept
Break-even logic
Break-even ED episodes = First-year incremental POCUS program cost ÷ value per avoided ED episode
Required POCUS-attributable ED reduction = Break-even ED episodes ÷ baseline ED referrals

This threshold tells the user what effect would be required for economic break-even. It is not a prediction that POCUS will achieve that effect.

Planning estimate only. Results are not guaranteed financial savings and do not constitute medical, accounting, reimbursement, or protocol advice. The default 10% relative ED-referral reduction is a conservative POCUS contribution scenario—not a published ultrasound-only effect—and should be replaced with local outcome data whenever available. This tool estimates the incremental contribution of POCUS to an existing MIH/community-paramedicine program and does not attribute the full economic effect of MIH to ultrasound.