Health Care 1 Doctor

Health: Military and Veterans Health Care (2012-15)

The Departments of Defense and Veterans Affairs need to improve integration across care coordination and case management programs to reduce duplication and better assistservicemembers, veterans, and their families.

Year Identified: 2012
Area Number: 15
Area Type: Fragmentation, Overlap & Duplication


Action 1

To improve the effectiveness, efficiency, and efficacy of services for recovering servicemembers, veterans, and their families by reducing duplication and overlap, theSecretaries of Defense and Veterans Affairs should direct the Senior Oversight Committee to expeditiously develop and implement a plan to strengthen functional integrationacross all Department of Defense (DOD) and Department of Veterans Affairs (VA) care coordination and case management programs that serve this population.

Executive Branch
Last Updated
March 31, 2020

In September 2012, the VA/DOD Joint Executive Council (into which the Senior Oversight Committee has been merged) approved an integrated, interagency approach that is intendedto reduce redundancy and overlap, and strengthen functional integration between the departments' care coordination and case management programs for recovering servicemembers,veterans, and their families, as GAO recommended in October 2011. The departments agreed to establish a joint task force to recommend interdepartmental action. The JointExecutive Council approved recommendations made by this task force, urged the departments to accelerate implementation of the recommended changes, and created the InteragencyCare Coordination Council (IC3) to oversee development and implementation of joint VA/DOD care coordination initiatives. Under the IC3, DOD and VA agreed to jointly implementtwo initiatives: (1) the Lead Coordinator process and (2) a single, comprehensive care coordination plan for each recovering servicemember.called the interagency care plan(ICP). 1. By November 2017, DOD and VA began to administer Lead Coordinator training to staff in both departments. In March 2019, Veterans Health Administration (VHA)officials told GAO that Lead Coordinators are being used at both VHA and DOD. 2. In March 2019, VHA officials told GAO that VA and DOD were not able to develop a shared ITplatform that would expedite the transfer of information on servicemembers transitioning from DOD to VA through an ICP as previously envisioned. Instead, officials stated thatVHA and DOD are sharing clinical and non-clinical information for program participants through transition checklists and other forms. This information is being transmitted byvarious methods, such as encrypted email, secure access file exchange, fax, or hand delivery. By implementing these recommendations, the departments have taken steps toimprove the efficiency of care coordination for recovering servicemembers and veterans and reduce the likelihood of duplicative efforts that could result in confusion andpotentially hamper their recovery. Further, in November 2018, DOD and VA took steps to strengthen the oversight and more closely integrate care coordination efforts byestablishing a Care Coordination Business Line within their joint Health Executive Committee. The Care Coordination Business Line is led by program-level VA and DOD directors,who report to the co-chairs of the Health Executive Committee. This entity is intended to (1) ensure that key issues affecting recovering servicemembers and veterans getsufficient consideration; (2) develop mechanisms for making joint policy decisions; (3) involve the appropriate decision makers for timely implementation of policy; and (4)establish mechanisms to systematically oversee joint initiatives and ensure that outcomes and goals are identified and achieved.

Implementing Entity:
Department of Defense
Department of Veterans Affairs
GAO Contacts