VA Health Care:

Retargeting Needed to Better Meet Veterans' Changing Needs

HEHS-95-39: Published: Apr 21, 1995. Publicly Released: Apr 21, 1995.

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Pursuant to a congressional request, GAO provided information on veterans' health care, focusing on: (1) whether the Department of Veterans Affairs' (VA) health care system is meeting veterans' health care needs; (2) why most veterans never use VA health care services; and (3) options available for reconfiguring the VA health care system to better meet veterans' needs.

GAO found that: (1) the VA health care system does not adequately address the health care needs of many veterans because of limited space and resources and its reliance on VA facilities; (2) about one-third of the nation's homeless are veterans who have limited access to health services and may not seek medical treatment; (3) about 38 percent of male and 25 percent of female Vietnam veterans with Post Traumatic Stress Disorder (PTSD) have not sought medical treatment; (4) many uninsured veterans do not use VA health facilities because they do not realize they are eligible for or do not trust VA care; and (5) options to better meet veterans' health care needs include expanding existing health care programs, authorizing veterans to enroll in the Federal Employees Health Benefits Program, changing the eligibility requirements for VA care, retargeting VA acute care resources to increase outreach to homeless veterans, expanding services for substance abusers and the mentally ill, identifying and treating veterans with PTSD, and expanding long-term care services.

Recommendations for Executive Action

  1. Status: Closed - Not Implemented

    Comments: VA eligibility was expanded by legislation enacted in October 1996.

    Recommendation: The Secretary of Veterans Affairs should assess the costs associated with any expansion of VA eligibility and identify and evaluate options for paying for any such expansions.

    Agency Affected: Department of Veterans Affairs

  2. Status: Closed - Not Implemented

    Comments: VA disagreed with the recommendation and has no plans to retarget VA resources toward supplemental services available under other health benefits programs. VA is, however, planning to revise which services it provides directly and which it provides through contracts.

    Recommendation: In considering options, the Secretary of Veterans Affairs should, to the extent feasible, retarget VA resources toward supplementing rather than duplicating health care services available under other public and private health benefits programs.

    Agency Affected: Department of Veterans Affairs

  3. Status: Closed - Not Implemented

    Comments: VA disagreed with the recommendation and does not plan to develop legislative proposals. With enactment of eligibility expansion and contracting reforms in October 1996, VA has the basic authority it would need to restructure the program to better meet veterans' needs.

    Recommendation: The Secretary of Veterans Affairs should, in concert with veterans service organizations and other federal and state agencies with jurisdiction over health benefits programs, develop legislative proposals to restructure the veterans health benefits program.

    Agency Affected: Department of Veterans Affairs

  4. Status: Closed - Not Implemented

    Comments: VA does not agree with the recommendation and does not plan to implement it. VA is, however, developing plans to restructure its health care system through its Veterans Integrated Service Network. These actions include establishment of community-based clinics which should include access to outpatient care for some veterans. GAO's recent testimonies, however, continue to show that VA is placing inadequate emphasis on service uninsured veterans.

    Recommendation: The Secretary of Veterans Affairs should, in concert with veterans service organizations and other federal and state agencies with jurisdiction over health benefits programs, identify and evaluate options to better target VA resources to meet the health care needs of veterans.

    Agency Affected: Department of Veterans Affairs

  5. Status: Closed - Not Implemented

    Comments: VA disagreed with the recommendation and identified no plans to reevaluate VA's role in meeting the long-term care needs of veterans. In a recent proposal, however, the Undersecretary for Health did suggest greater use of community nursing homes.

    Recommendation: The Secretary of Veterans Affairs should reevaluate the VA role in meeting the long-term care needs of an aging veteran population and explore options, such as estate recoveries and cost sharing, for paying for any expanded role.

    Agency Affected: Department of Veterans Affairs

 

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