In rural areas and under-resourced communities, millions of people call 911 for help with problems that should never have become emergencies. Aaron Molloy watched it all up close from the back of an ambulance in Revere, Massachusetts.

“We saw people daily who could stand at their front door and almost see Mass General Hospital,” Aaron says. Yet even within sight of one of the world's top hospitals, the patients he met couldn't manage their chronic conditions.

During 20-hour shifts every Thursday, riding in Ambulance 5, Aaron realized his team of EMTs was hemmed in. They had the skills and means to be proactive, but the system only allowed them to be reactive.

By the time he showed up to treat someone in the grip of congestive heart failure, it was already too late. Those patients needed someone checking in weeks earlier—monitoring their weight, adjusting their medications—before a bad day became a 911 call.

That epiphany became Paralign: the company he founded to unlock what paramedicine can do when and where people really need it. And most importantly, when there's a funding model to support it.

From a Bird's-Eye View to the Front Line

Before founding Paralign, Aaron had spent years at McKinsey in healthcare policy and strategy, observing these same issues from a distance. He decided that to have a real impact, he’d need to understand how things really work on the front line.

During COVID, Aaron had the opportunity to work with the state government on their COVID command team. In that role, he became inspired by the people living it up-close. “I thought, it's kind of ironic that I advise all these healthcare leaders,” Aaron says, “but I don't know how to take blood pressure."

What was it actually like to deliver patient care? He’d always reported on the shortage of EMTs and paramedics. Now he felt it was time to become part of the solution and not just analyze the problem. So, Aaron became an EMT himself. 

While working on the ambulance, Aaron saw that paramedics needed help and communities needed more from paramedicine. He'd met amazing people, but discovered the system wasn't set up to support them. That’s when Aaron connected with Healthworx Studio, which had identified a similar opportunity. After an initial test phase, Paralign spun out on its own.

The concept has existed for 30 years—it’s called Mobile Integrated Healthcare (MIH). But while you can’t call it a novel idea, the business case is. No one has yet built a funding model that can scale—until now.

Getting Departments Paid for Work They're Already Doing

According to Aaron, 70 percent of the $4.9 trillion spent on U.S. healthcare flows through Medicaid, Medicare, and private insurance, which is funding that fire and EMS departments in rural areas can’t access. They’re funded by municipal budgets and grants that barely cover the cost of what they’re already asked to do.

So, while there’s infrastructure in place, those programs are understaffed and lack access to the same funding that fuels the larger healthcare system. Aaron built Paralign to close that gap by connecting the people doing this work to the dollars that could pay for it. With proper funding, departments that max out at 5 paramedics could support 15.
 

The idea is to partner with fire and EMS departments that have established relationships in the community. Paralign gets them compensation while coordinating reporting and administration on the backend. 

He points out that community paramedicine isn’t meant to replace primary care. For every few visits by a paramedic, there should be a touchpoint with a primary care provider. Ultimately, the goal is to stabilize people with acute needs and then graduate them from the program.

Right Care, Right Place, Right Time

What does it look like in practice? Aaron relates the story of one patient in Missouri who’d dialed 911 no fewer than 140 times, with 65 emergency transports in a single year. After enrolling in an MIH program, the number of calls the following year dropped to just 8—with zero trips to the ER. Those numbers translate to something that’s harder to quantify: having an advocate in patients’ homes means a better quality of life.

The positive impact on first responders is obvious, too. Those 132 calls that never happened freed crews to respond to true emergencies, where every minute counts. It’s a more proactive approach that also reduces burnout.

For payers, the model delivers savings. That happens when patients have access to preventive care and community paramedicine that keeps them out of the hospital and the ICU.

Aaron thinks the math is straightforward. For patients consuming $70k or more in annual healthcare costs, an intervention by a community paramedic can reduce that by $15k to $20k. After factoring in the cost of the program, that represents a 4-to-1 return for the health plan.

What's Next for Paralign

Paralign has concluded a $3 million seed round. The round was led by Flyover Capital, with participation from SixThirty Ventures, SpringTime Ventures, Forum Ventures, Sorenson Impact Foundation, Stone Mountain Ventures, and Govtech Ventures. 

Aaron wants to bring a million EMS workers into the fold, moving them from the public-safety sidelines into the larger healthcare ecosystem. Early signs suggest the traction is there.

Today, Paralign partners with 11 of the largest ambulance and fire protection districts in Missouri and is finalizing its first Medicaid MCO contract. By Q3 2026, Aaron expects to have aggregated data that tells the more complete story. From there, Paralign plans to triple Missouri partnerships and expand to Wisconsin, Montana, Kansas, Florida, and Maryland, where interest is already high.

"It's not a small undertaking,” Aaron says. “It's a lofty goal, but it all comes with aligning incentives. And in this case, I think the incentives can't be clearer. It's win, win, win for everybody."