VA/DOD Health Care: Further Opportunities To Increase the Sharing of Medical Resources
HRD-88-51
Published: Mar 01, 1988. Publicly Released: Mar 01, 1988.
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Highlights
In response to a congressional request, GAO reviewed the Veterans Administration's (VA) and the Department of Defense's (DOD) implementation of legislation to promote their sharing of health care resources, to determine: (1) whether the two agencies took full advantage of opportunities to share their resources; (2) the adequacy of current incentives to share resources; (3) whether there were any barriers to their sharing arrangements; and (4) whether administrative or legislative changes could further encourage sharing.
Recommendations
Matter for Congressional Consideration
| Matter | Status | Comments |
|---|---|---|
| Congress should enact legislation authorizing VA to accept all categories of DOD beneficiaries under a VA/DOD sharing agreement on a space-available, referral basis when care of VA beneficiaries would not be adversely affected. Specifically, 38 U.S.C. 5011(d)(1) should be amended to remove the restriction on VA providing health care to DOD beneficiaries. |
Closed – Not Implemented
|
Congress is not amenable to expanding VA beneficiary population, but the National Defense Authorization Act for Fiscal Year (FY) 1990 provided authority to the military services to use CHAMPUS funds to reimburse VA for services procured under VA/DOD sharing agreements. |
| Congress should amend the National Defense Authorization Act for fiscal year 1987 to specifically authorize the military services to use CHAMPUS funds to purchase care from VA medical centers, when it is cost-effective to do so. |
Closed – Implemented
|
The National Defense Authorization Act for FY 1990 incorporated this recommendation. |
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Defense | The Administrator of Veterans Affairs and the Secretary of Defense should enhance VA and DOD medical sharing opportunities by notifying each of their medical center directors, hospital commanders, and audit and inspection organizations that, under the VA/DOD Health Care Resources Sharing Guidelines, reimbursement rates may be locally negotiated at less than total cost. |
Closed – Implemented
DOD and VA are jointly revising sharing guidelines to implement this recommendation. Revised guidelines were published in May 1989.
|
| Veterans Administration | The Administrator of Veterans Affairs and the Secretary of Defense should enhance VA and DOD medical sharing opportunities by notifying each of their medical center directors, hospital commanders, and audit and inspection organizations that, under the VA/DOD Health Care Resources Sharing Guidelines, reimbursement rates may be locally negotiated at less than total cost. |
Closed – Implemented
DOD and VA are jointly revising sharing guidelines to implement this recommendation. Revised guidelines were published in May 1989.
|
| Department of Defense | The Secretary of Defense should direct the Assistant Secretary of Defense (Comptroller), in consultation with the service secretaries, to develop procedures to ensure that DOD hospital managers are explicitly informed of the amounts of resources being provided to handle anticipated reimbursable work under Public Law 97-174. |
Closed – Implemented
DOD planned to issue guidelines to implement this recommendation by October 1, 1988. However, congressional action in the appropriations process delayed this until early 1989. Guidelines issued in May 1989 will implement this recommendation.
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Health care cost controlHealth care costsHealth care planningHealth resources utilizationInteragency relationsMilitary health servicesMilitary hospitalsMilitary personnelProgram managementProposed legislationVeterans hospitals