Expansion of joint health care services between VA and DoD, yet evaluating their effects proves challenging
The joint health care agreements between the Department of Veterans Affairs (VA) and the Department of Defense (DoD) aim to streamline the transition of care for veterans, focusing on interoperability and data sharing to improve cost savings and access to care.
### Cost Savings and Access to Care
By sharing resources and health data, both departments can potentially reduce costs associated with redundant medical tests and procedures. The use of interoperable electronic health records (EHRs), such as MHS GENESIS and the VA's modernized system, can streamline health data exchange, potentially improving access to care for veterans by reducing delays in treatment and enhancing continuity of care. However, specific cost savings figures from these agreements are not clearly outlined in the provided sources.
### Challenges in Evaluating Effectiveness
Despite both departments transitioning to similar EHR systems, they still face challenges in making these systems work seamlessly together, which complicates the evaluation of their effectiveness. The integration of health data from different systems can be complex, leading to difficulties in assessing the true impact of these agreements on cost savings and access to care. Additionally, there is a need for more comprehensive metrics and studies that specifically quantify the cost savings and access improvements resulting from these agreements.
### Future Directions
To enhance the effectiveness of VA-DoD health care sharing agreements, ongoing efforts to improve interoperability, such as the transition to cloud-based systems, are crucial. Additionally, implementing more robust evaluation frameworks to measure outcomes will be essential for assessing the actual benefits of these agreements.
Accessing military bases continues to be a challenge for veterans in implementing these shared agreements. As of 2024, the VA cleared a backlog of over $87 million in unpaid claims to DoD facilities from fiscal 2018 through 2022, but administrative hurdles persist.
An emerging area of concern is developing non-reimbursable agreements for sharing health care resources. These agreements allow for the sharing of facilities, medical staff, administrative personnel, and non-medical services like training or laundry services. However, less than 1% of agreements represent fully integrated healthcare operations, and about 30% involve embedded personnel, where VA or DoD clinicians or administrative staff work directly at the other agency's facility.
The challenge of veterans accessing military bases remains a constant issue in implementing shared health care agreements. The Defense Department limited the use of these agreements following concerns in 2020 that some were not mutually beneficial.
In conclusion, while VA-DoD health care sharing agreements hold promise for improving cost savings and access to care, challenges remain in evaluating their effectiveness and overcoming administrative hurdles. Ongoing efforts to improve interoperability and develop robust evaluation frameworks will be key to unlocking the full potential of these agreements.
The reimagined workforce, brought together by these agreements, could potentially collaborate on medical-conditions research, further enhancing health-and-wellness outcomes for the federal workforce. Integrating EHRs from both the Department of Defense and the Department of Veterans Affairs could provide valuable data for scientific studies, leading to advancements in healthcare.
In light of the complexities and administrative hurdles in implementing these health care sharing agreements, it's crucial to consider non-reimbursable agreements for sharing health care resources, such as facilities, medical staff, and non-medical services, to optimize cost savings and access to care for veterans.
