Be In The Know
April 4, 2025
EMS Compassionate Billing a Grassroots Effort Led by Volunteer Rescue Council
VBEMS and Rescue Council are partnering to explore billing for ambulance transports to establish sustainable funding for the system.
More than a year ago, the Council of Virginia Beach Volunteer Rescue Squads, Inc. (Rescue Council) — with support of Virginia Beach City Council and Virginia Beach EMS (VBEMS) — commissioned a feasibility study to look at cost recovery options for ambulance transports. The Rescue Council is a democratic representative body that represents the 10 volunteer rescue squads. It is also the formal advisory board to the city manager and EMS chief on matters related to the rescue squads.
Virginia Beach is the only locality in Hampton Roads that does not conduct EMS billing. Consultant AP Triton conducted the study and used a data-driven approach to evaluate whether a compassionate billing program was feasible as a potential funding source for the EMS combined system.
Funding Challenges
The past few years, rescue squads have been challenged to fund ambulances, equipment and supplies. The Rescue Council realized a need to find additional funding to sustain and maintain the rescue squads.
- Volunteer Rescue Squad expenses have increased more than 40% in the last three to four years.
- Volunteer fundraising efforts have not increased proportionately.
- The number of active volunteers has decreased since 2019.
The importance of system sustainability and the need to identify additional funding was also a priority in VBEMS’ updated 2024 strategic plan.
The feasibility study determined that billing patients’ health insurance could provide more than $14 million in annual funding for volunteer rescue squads and EMS.
Moving Forward
Compassionate billing started as a Rescue Council initiative — and with the study findings — all 10 rescue squads agreed moving forward was the best path to sustainable funding. They adopted a position statement of support to move forward with the development of an EMS billing program.
On Dec. 10, 2024, City Council approved a resolution to start the exploratory process of a compassionate billing program for emergency medical services through the FY 2025-26 budget process. A compassionate billing program is not finalized until the budget is adopted on May 13.
A Transparent and Equitable Partnership
VBEMS and Rescue Council worked together to produce an equitable plan on how the funds would be divided between the two groups. This was part of Rescue Council’s contingencies in its support of moving forward with a compassionate billing program:
- Money from compassionate billing does not go into the City’s general fund. A special fund is established and is allocated only to EMS operating expenses and rescue squad expenses.
- Fund allocation be managed with transparency and involvement of the Rescue Council.
- An equitable method of distribution developed, so that rescue squads can get their fair share of funding.
EMS Chief Jason Stroud and Rescue Council President Mike McCracken hosted two VBEMS member info sessions on March 3 and March 6, where they discussed the program timeline, exploratory process and how funding will be equitably divided.
They also highlighted how the program will fund:
- Pharmaceuticals (EMS Pharmacy Program)
- Purchase of ambulances and equipment
- Medical supplies
- Volunteer recruitment and retention initiatives
- Extra response positions to bolster ambulance staffing
Next Steps
- Educating the Public: VBEMS and the City’s Communications Office are working to educate residents about the program leading up to City Council’s final consideration in May.
- Administrative: The administrative pre-work to initiate compassionate billing on July 1, 2025, should it be approved by City Council, is underway.
- Includes partnering with the third-party EMS billing company, Digitech Inc.
- Establishment of related policies and infrastructure.
- Application process for provider ID number(s) and billing credentials.
- Budget Process: Staff have included EMS compassionate billing as part of the FY 2025-26 budget process. This includes authorizing ordinance(s), fee schedule and memorandum of understanding with Rescue Council.
EMS is an award-winning third-service agency that answers more than 53,000 calls for service annually. Through VB Rescue, EMS uses a combined career-volunteer workforce and was named a 2024 American Heart Association Mission: Lifeline Gold EMS Agency. Learn more about EMS by visiting ems.virginiabeach.gov. You can also contact Virginia Beach EMS at vbems@vbgov.com.
