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VA Health Care: Improvements Needed in Capital Asset Planning and Budgeting

HEHS-99-145 Published: Aug 13, 1999. Publicly Released: Aug 13, 1999.
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Highlights

GAO reviewed the Department of Veterans Affairs' (VA) management of health care assets.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Veterans Affairs The Secretary of Veterans Affairs should develop asset-restructuring plans for all markets to guide future investment decision-making. These plans should comply with OMB's guidelines and incorporate best practices of industry as well as those of VA's 181 delivery locations.
Closed – Implemented
On August 4, 2003, the Secretary of Veterans Affairs publicly released a plan to restructure the capital assets used in VA's healthcare delivery system. Consistent with OMB's guidelines, the Secretary's plan covers every VA service delivery market and recommends a wide range of asset realignment alternatives, including closing delivery locations, opening new ones, consolidating healthcare services among existing delivery locations, and modernizing existing locations.
Department of Veterans Affairs Until more effective capital asset planning is in place, the Secretary of Veterans Affairs should require that a larger share of health care investment decisions be made using VA's centralized budget process.
Closed – Not Implemented
VA does not concur with this recommendation and does not plan to take any further action.
Department of Veterans Affairs Until more effective capital asset planning is in place, the Secretary of Veterans Affairs should ensure that the fundamental principles underlying that process are rigorously implemented when making decentralized health care investment decisions.
Closed – Implemented
In fiscal year 2001, VA established a Capital Asset Management Board at headquarters to review and approve minor construction proposals. The new process helps ensure that all capital asset investment decisions reflect the most efficient and effective use of resources to meet the Department's mission, vision, and goals.
Department of Veterans Affairs To reduce subjectivity and thereby enhance the credibility of VA's centralized budget process, the Secretary of Veterans Affairs should modify written guidelines to describe, in greater detail, minimum quantitative data required for each decision criterion.
Closed – Implemented
VA's Capital Investment Board continually evaluates its capital investment process to ensure objectivity. VA has retained professional consultants to review and recommend modifications that reflect the best practices in industry as well as within VA.
Department of Veterans Affairs To reduce subjectivity and thereby enhance the credibility of VA's centralized budget process, the Secretary of Veterans Affairs should exclude from the prioritization process all capital investment proposals that fail to meet the information requirements.
Closed – Implemented
VA has incorporated in its planning guidance capital investment process requirements. VA plans to enhance training opportunities for field staff involved in preparing applications for proposed capital investments.

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Topics

AssetsCost controlCost effectiveness analysisFinancial managementHealth resources utilizationManagement reengineeringStrategic planningVeterans benefitsVeterans hospitalsVeterans' medical care