VA Health Care:

VA Has Not Sufficiently Explored Alternatives for Optimizing Third-Party Collections

GAO-01-1157T: Published: Sep 20, 2001. Publicly Released: Sep 20, 2001.

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Stephen P. Backhus
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The Department of Veterans Affairs (VA) has reversed the general decline in its third-party collections for the first time since fiscal year 1995. The fiscal year 2001 increase appears to be largely the result of VA's implementation of a new system, known as the reasonable charges billing system, which allowed VA to move from a flat-rate billing system to one that itemizes charges. However, long-standing problems in VA's revenue operations persist, and VA's collections performance is poor when compared to that of the private sector. VA's attempts at consolidation using either in-house or contractor staff have provided little basis for selecting the best alternative to VA's collections problems. Also, VA's recent 2001 Revenue Cycle Improvement Plan does not call for a comprehensive comparison of alternatives, nor does it focus on net revenues--collections minus operations costs. To collect the most funds for veterans' medical care at the lowest cost, VA needs to develop a business plan and detailed implementation approach that will provide useful data for optimizing net revenues from third-party payments.

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