Health Care Spending and Efficiency in the U.S. Department of Veterans Affairs
Jul 2, 2013
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The Veterans Health Administration (VHA), part of the U.S. Department of Veterans Affairs (VA), provides comprehensive health care services to veterans. Yet most health care received by veterans is delivered by private-sector providers outside the VHA, financed by private insurance or Medicare. Coordination of care can be a significant challenge for veterans navigating these dual systems of care, each of which has its own providers, incentives, and regulations.
The large and growing prevalence of mental health issues, such as post-traumatic stress disorder and traumatic brain injury, among younger and returning veterans amplifies the need for effective and coordinated care across sectors: Ensuring the mental health of veterans often spans the full health care continuum and requires additional providers and service sectors, such as community-based and social support programs. In addition, mental health problems can intensify general health care needs.
Relying on both original data analysis and prior literature, a team of RAND researchers analyzed challenges inherent in this complex system of care for veterans, focusing on coordination of care and efficiency concerns. The analysis found that:
Based on this analysis, the authors suggest that the VHA explore the following options through geographically defined pilot programs (or as part of existing programs) that may improve care for veterans:
To determine whether such changes improve efficiency, future evaluations should consider ease of implementation and assess impacts in several areas, including quality of care; equity in resource allocation; feasibility; and VA, federal, and other spending.
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