May 2, 2025

These Are the Lifesaving Programs and Initiatives Compassionate Billing Will Fund

Billing for ambulance transports is expected to generate more than $14 million in annual funding for volunteer rescue squads and EMS.

VBEMS Pharmacy Program

Since 2021, operational and equipment costs for emergency medical services agencies across the country have skyrocketed. Virginia Beach Emergency Medical Services’ (VBEMS) expenses have nearly doubled, while volunteer rescue squad expenses have increased more than 40%. 

VBEMS and the Council of Virginia Beach Volunteer Rescue Squads, Inc. (Rescue Council) recognized the need to find an additional revenue source to fund the department’s commitments and maintain the rescue squads. The Rescue Council — with City Council and VBEMS support — commissioned a feasibility study to look at cost recovery options for ambulance transports.  

With the findings, all 10 rescue squads 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 through the FY 2025-26 budget process.  

A Sustainable Revenue Source 

The feasibility study determined that billing patients’ health insurance could generate more than $14 million in annual funding for volunteer rescue squads and EMS. If approved by City Council, revenue from compassionate billing will be dedicated to a new Cost Recovery Special Revenue Fund (SRF). The funding will be equitably distributed between the two organizations.  

Provide Relief 

Revenue generated from compassionate billing will fund lifesaving programs and advanced medical initiatives system-wide, including:  

  • Enhanced medical equipment – VBEMS is a leader of prehospital clinical care and provides the community with premier services. This will include the deployment of prehospital ultrasound, automated ventilators, intravenous therapy pumps, and an additional whole blood unit. These initiatives help ensure that VBEMS brings the best possible care to the patients’ side. 
  • Additional Response Personnel – Additional personnel, both career and volunteer, are needed to meet the ever-increasing demand for services. New volunteer recruitment and retention programs will be launched, and additional career advanced life support (ALS) members will be added. The additional support will allow VBEMS to continue providing quality services, while not overtaxing existing members, ensuring meaningful and equitable opportunities for both career and volunteer members. 
  • Pharmaceutical – In 2024, the department established an in-house pharmacy management program due to changes in federal law. The new regulatory mandate required EMS agencies to handle their own medication restocking. This meant the city had to take on the one-time and ongoing costs related to the establishment of the pharmacy program. Revenue from compassionate billing will be able to support the continuation of this vital program. 
  • Ambulances for Volunteer Rescue Squads – In order to maintain the current level of service in upcoming years, the city needs at least four additional ambulances in its fleet. The cost of an ambulance has increased significantly since 2020. A new, personalized ambulance can cost around $350,000 or more. An important note: ambulances are owned by the rescue squads, but the City provides maintenance upkeep and fuel. 

Next Steps   

  • Educating the Public: VBEMS and the City’s Communications Office continue to educate residents about the program leading up to City Council’s final consideration on May 13. 
  • 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.    

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