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VA Health Care: Opportunities for Service Delivery Efficiencies Within Existing Resources

HEHS-96-121 Published: Jul 25, 1996. Publicly Released: Jul 25, 1996.
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Highlights

Pursuant to a congressional request, GAO provided information on the Department of Veterans Affairs' (VA) health care system, focusing on ways that VA could: (1) operate more efficiently; (2) reduce the resources needed to meet veterans' health care needs; and (3) reorganize its health care system and create efficiency incentives.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Veterans Affairs The Secretary of Veterans Affairs should establish an independent, external preadmission certification program for VA hospitals.
Closed – Implemented
VA's networks have established preadmission certification programs. These programs, however, do not involve contracts with independent external reviewers or any financial risk/incentives for VA physicians to adhere to the review findings.
Department of Veterans Affairs The Secretary of Veterans Affairs should provide Congress, through future budget submissions, data on the extent to which VA services were provided to veterans in the mandatory and discretionary care categories for both inpatient and outpatient care.
Closed – Not Implemented
Under its new legislatively mandated eligibility process, medical services are mandatory for about 89 percent of all veterans using VA's healthcare system. As such, it no longer seems useful for VA to provide data on mandatory and discretionary care.
Department of Veterans Affairs The Secretary of Veterans Affairs should include in future budget submissions: (1) information on costs saved through improved efficiency; and (2) plans to either reinvest savings in new services or programs or use the savings to reduce the budget request.
Closed – Not Implemented
VA disagreed with the recommendation and has no plans to track savings from efficiency initiatives. VA believes that accountability will be secured through other monitoring processes, including the Government Performance and Results Act.

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Topics

Cost effectiveness analysisFederal agency reorganizationFuture budget projectionsHealth care cost controlHealth resources utilizationHealth services administrationHospital care servicesMedicarePatient care servicesVeterans benefitsVeterans hospitalsVeterans' medical care