VA Health Care: Allocation Changes Would Better Align Resources with Workload.

摘要

The Department of Veterans Affairs (VA) spent about $21 billion for health care in fiscal year 2001 to treat about 3.8 million veterans.most of whom had service-connected disabilities or low incomes. Since fiscal year 1997, VA has used the Veterans Equitable Resource Allocation (VERA) system to allocate most of its medical care appropriation as part of its overall strategy to reform VA health care. As a health care payer, like the Medicare and Medicaid programs, VA faces the challenge of allocating resources to account for differences in patient workload treated, encourage efficiency, and ensure quality. As a direct provider, VA also operates a major health care system consisting of 22 regional health care networks that are at risk for budget shortfalls if the cost of providing care to veterans treated by the network is greater than available resources. Congressional stakeholders have expressed concern as to whether VERA has been designed and implemented to allocate resources commensurate with workload. To address concerns you raised, this report (1) describes the effect VERA has had on network resource allocations and workloads, (2) assesses whether VERA's design is a reasonable approach to resource allocation, and (3) identifies weaknesses in VERA that may limit VA's ability to allocate comparable resources for comparable workloads. As agreed with your offices, we focused our work on VERA's allocation of resources from headquarters to the networks, but we did not examine the extent to which networks in turn allocate comparable resources for comparable workloads to their respective facilities and programs.