Every year, thousands of Americans are rushed to emergency rooms with gunshot wounds — and for many, the hospital visit is just the beginning of a cycle that can cost millions of dollars and, far too often, repeat itself. A growing network of hospital-based programs across Virginia is working to break that cycle before it starts, and the results are showing up in both human lives and hospital budgets.
According to the Virginia Hospital & Healthcare Association, hospital-based violence intervention programs statewide have served nearly 10,000 patients since 2019 and helped avoid an estimated $101.8 million in health care costs. In Hampton Roads alone, four of those programs have reached 5,290 patients since March 2020.
For families already struggling with medical bills and insurance gaps, these programs represent something rare in American health care: a system that tries to prevent the crisis instead of just treating it.
What These Programs Actually Do
Hospital-based violence intervention programs, often called HVIPs, connect gunshot survivors and other victims of violent injury with support services while they’re still in the hospital — and follow up with them long after discharge. That includes trauma-informed counseling, safety planning, transportation, housing resources, and referrals to community organizations.
Sentara Norfolk General Hospital runs the Foresight Violence Intervention Program, one of the region’s four active programs. Fitzroy Smith, who supervises the program, says the financial case for these interventions is just as strong as the human one.
“It really demonstrates that hospital intervention programs are not just mission-driven. We’re also financially responsible. When you stabilize patients, you also stabilize hospital systems,”
Smith told WHRO News.
The numbers back that up. A single gunshot injury can cost between $30,000 and $50,000 to treat. A homicide carries even steeper costs to the health system — and to society.
“So the hospital has to bear the burden. Now, for a homicide, it’s anywhere from $1.6 million to $3 million per individual,”
Smith said.
Much of that financial burden falls on hospitals because many gunshot victims are uninsured, underinsured, or covered by Medicaid — meaning the hospital absorbs costs that never get fully reimbursed. For families already on the financial edge, a gun injury can be devastating in ways that go far beyond the emergency room.
Stopping the Cycle Before It Repeats
One of the most striking findings from Virginia’s data is what happens when patients don’t receive intervention services. The Virginia Hospital & Healthcare Association reports a re-injury rate of just 3% among patients enrolled in these programs — compared to an estimated 40% re-injury rate among victims who receive no follow-up support. That reduction alone accounts for more than $49 million in avoided health care costs.
Smith explained why keeping people out of the hospital matters as much as treating them once they arrive.
“When you interrupt violence, that’s an added responsibility that’s taken off of the hospitals because they have to treat the individual that comes into that hospital room. Our job is to make sure they don’t come there in the first place,”
he said.
January Serda, grant coordinator for Riverside Hospital’s Hand-In-Hand Violence Intervention Program, echoes that philosophy. She says the programs address not just immediate injuries but the underlying conditions — behavioral health needs, housing instability, lack of access to outpatient care — that make violence more likely to recur.
“None of us are saviors over here. What we’re really doing is empowering that individual to tap into their own strength and power and resiliency to save themselves,”
Serda said.
Research Is Key to Making These Programs Work
Understanding which interventions actually reduce gun violence — and for whom — requires rigorous research. Virginia Commonwealth University recently launched a new Center for Gun Violence Research to do exactly that. Nicholas Thomson, the center’s director and associate dean for research in VCU’s School of Public Health, says the goal is to partner directly with the community organizations running these programs.
“We see ourselves as a key partner in these community organizations in the gun violence prevention initiatives,”
Thomson said.
That research includes tracking firearm injuries, measuring changes in violent behavior among youth, and — critically — identifying risk factors before violence happens at all.
“Much of our research really does need to focus on a prevention standpoint. So, that’s identifying what risk factors lead to gun violence. And that’s really the mechanism that we’re trying to target before these youth or people engage in gun violence,”
Thomson said.
Virginia now has 12 hospital-based violence intervention programs across 10 health systems — a network that has expanded in 2026 with the addition of programs at Ballad Health’s Johnston Memorial Hospital in Abingdon and UVA Health in Charlottesville. Other participating systems include Bon Secours in Richmond, Carilion Clinic in Roanoke, Children’s Hospital of The King’s Daughters in Norfolk, INOVA in Fairfax, and Chesapeake Regional Medical Center.
Chesapeake Regional’s Healing Opportunities Providing Empowerment (HOPE) program is currently on pause following personnel changes, according to a hospital spokesperson.