HomeMy WebLinkAboutEMS COMPASSIONATE BILLING UPDATEOctober 20, 2026
EMS Compassionate Billing Program
Update
OVERVIEW
•Provide background information related to how we have arrived at this point
•Provide a quick timeline of its pre-and post-implementation
•Provide insights on how EMS Billing is going
•Highlight programs and initiatives funded from EMS Billing revenue
•Discuss next steps and answer any questions
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COMPASSIONATE BILLING
•November 2024 –Third-party study presented to City Council
•December 2024 –Councilmembers approved resolution to start exploratory
process:
▪Establish related policies and infrastructure
▪Partner with third-party EMS billing company
▪Begin public education campaign to inform residents about the program
•May 2025 –Program formally approved by City Council
•July 1, 2025 –VBEMS begins billing for ambulance transports and some ALS
treatments
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FY2026
•30,951 Transports (26,700 residents, 4,251 non-
residents)
•$18.5million billable
•$2.8million copays/co-deductibles written off
•$2.3million adjustments and contractual
settlements.
•$13.4million posted-to-date
FY2027
•Monthly receivables ranging $1.2-$1.5million
How is EMS Billing going?
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Patient Data
86%
14%
Resident vs Non-Resident
Resident Non-Resident
54%
18%
9%
13%
6%
Payer Mix
Medicare Medicaid Commercial Insurance Patient Pay Other
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Major EMS Billing Accomplishments
•30% Distributed directly to Volunteer Rescue Squads =
$4.2million
•Provided funding for seven (7) additional ambulances.
•Recruitment grant provided to the VB Rescue Foundation
•43 additional uniformed staff, and multiple support staff.
•Centralized medical supplies and full development of
Pharmacy Program
•Advanced Life Support Training for 39 providers.
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Compassionate Billing has also provided …
STAFF, RESOURCES & PROGRAMS
•Member Health and Wellness Programs
•Special Event Incentives (paid to rescue squads)
•Field Training Officer incentive program
CLINICAL INITIATIVES
•New pharmaceuticals
•IV Pumps
•Ventilators
•Point of Care Ultrasound
EQUIPMENT & FLEET
•Volunteer Marine Rescue Team Boat
•EMS Support Vehicles
•Special Events cart
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PROFESSIONAL DEVELOPMENT
•Development of new VBEMS Officer development
program.
BUILDING A SHARED VISION
“Provide exceptional prehospital care through seamless
teamwork, empowering a diverse system that provides
innovative and compassionate service.”
•2026 Strategic Realignment
•Led again by McChrystal Group
•Multiple interviews and two workshops
•Stakeholder involvement including City staff,
VBEMS staff, VB Rescue Council and Rescue
Squad(s) leadership, labor representation and
support staff.
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V i s i o n M i s s i o n
V i s i o n &
M i s s i o n
Virginia Beach EMS provides exceptional prehospital care through seamless teamwork,empowering a diverse system that provides innovative and compassionate service
To preserve life, improve health, and promote safety.
Values Clinical Excellence System Sustainability Professionalism Collaboration Community
Objectives Ensure equipment, assets,
facilities, and resources are ready
to meet current, and future,
operational demands.
Develop and sustain a capable and
resilient workforce with the
staffing, readiness, and retention to
meet system demand.
Develop a culture of
accountability, professionalism,
and open communication rooted
in organizational values.
Cultivate a strong leadership
pipeline prepared to meet
organizational needs.
Build a visible, trusted presence
in the community that
strengthens partnerships.
Initiatives 1)Establish standardized duty-readiness
practices so apparatus, equipment, supplies,
station resources, and vehicles are
consistently prepared across shifts and
locations.
2)Complete a fleet support review to
identify ambulance availability, maintenance
needs, replacement timelines, and where
internal or external support is required.
3)Complete a facilities needs assessment to
identify space, readiness, safety, storage,
and expansion requirements.
4)Establish a systemwide process for
tracking, prioritizing, and resolving
equipment, fleet, supply, and facility
readiness issues.
1)Identify and implement the predictable
minimum staffing requirements.
2)Develop recruitment pipelines that attract
qualified volunteer applicants into the
system.
3)Expand sustainable training pathways for
EMT, AEMT, ALS, and continuing education so
members can grow and stay in the system
4)Invest in a member experience that
supports retention, longevity, wellness, and
accountability.
1)Set clear expectations based on current
policy, organizational values, operational
needs, and performance data.
2)Use supervisor routines and
performance data to reinforce individual
ownership and equitable accountability.
3)Establish communication practices that
improve transparency between leadership,
supervisors, field providers, and partners.
4)Create feedback loops through surveys,
committees, and after-action processes so
members see how input leads to action.
1)Define competency standards and
decision rights for each rank and role.
2)Build a leadership development
pathway that includes succession planning,
leadership academy options, and
promotional assessment processes.
3)Review community-based professional
development resources that could
supplement internal training.
1)Conduct a gap analysis and business
case for agency accreditation to ensure
best-practices and comparative evaluation.
2)Identify community, civic, school,
healthcare, public safety, and nonprofit
partners aligned to VBEMS priorities.
3)Develop a prioritized outreach plan that
supports prevention, public education,
recruitment, trust-building, and awareness
of VBEMS’ role in the city.
4)Use community engagement and system
performance data to help tell a clear
funding and investment story to City
leadership and the public.
Metrics 1)Achieve 100% compliance with
standardized apparatus and equipment
check-off system by FY29.
2)Reduce ambulance downtime year over
year by FY29, using the Fitch fleet report as
the baseline.
3)Complete facilities needs assessment and
prioritized resource plan by FY29.
4)Establish equipment, fleet, supply, and
facility readiness dashboard by FY29.
5)Reduce unresolved equipment, fleet,
supply, and facility issues quarter over
quarter once baseline is established.
1)Meet 100% of adjusted minimum staffing
levels by FY29.
2)Increase qualified volunteer applicants by
10% for priority roles year over year.
3)Reduce regrettable attrition by 10% year
over year.
4)Increase participation in training and
advancement pathways year over year.
5)Average UHU remains at or below 0.50 at
least 75% of the time, during demand period
of 0900-2100hrs.
6)Average UHU remains at or below 0.25 at
least 75% of the time, during overnight hours
of 2200-0600hrs.
1)Reduce overdue task assignments by 5%
quarter over quarter.
2)Achieve 75% engagement in
organizational surveys, committees, or
formal feedback opportunities.
3)Increase participation in development
opportunities by 5% quarter over quarter.
4)Create a structured leadership feedback
and performance review process that
reinforces growth and accountability by
FY27.
1)Complete system leadership needs
review by June 2027.
2)Complete leadership development
framework and funding plan by end of
FY28.
3)Complete review of available
community training resources by June
2027.
4)50% of current Captains and above
complete a professional development
program by end of FY28.
1)Standard community presentation
completed and approved by FY27.
2)Establish annual outreach baseline, then
increase outreach engagements year over
year.
3)Track partner engagement, follow-up
actions, and resulting recruitment,
prevention, or education opportunities.
4)Complete accreditation gap analysis by
FY27 and define path to accreditation by
FY32.
5)Evaluate fundraising, donations, and
community support trends year over year.
Looking Ahead
•Evaluate best practices through accreditation.
•Increased community engagement.
•Continued standardization of the ambulance fleet.
•Maintain enough staffing to meet current demand.
•Assessment of facility needs and issues.
•Update EMS billing rates according to industry best-practices.
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QUESTIONS?
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