Balancing Demand and Supply for Veterans' Health Care: A Summary of Three RAND Assessments Conducted Under the Veterans Choice Act

Carrie M Farmer, Susan D Hosek, David M Adamson, Carrie M Farmer, Susan D Hosek, David M Adamson

Abstract

In response to concerns that the Department of Veterans Affairs (VA) has faced about veterans' access to care and the quality of care delivered, Congress enacted the Veterans Access, Choice, and Accountability Act of 2014 ("Veterans Choice Act") in August 2014. The law was passed to help address access issues by expanding the criteria through which veterans can seek care from civilian providers. In addition, the law called for a series of independent assessments of the VA health care system across a broad array of topics related to the delivery of health care services to veterans in VA-owned and -operated facilities, as well as those under contract to VA. RAND conducted three of these assessments: Veteran demographics and health care needs (A), VA health care capabilities (B), and VA authorities and mechanisms for purchasing care (C). This article summarizes the findings of our assessments and includes recommendations from the reports for improving the match between veterans' needs and VA's capabilities, including VA's ability to purchase necessary care from the private sector.

Figures

Figure 1.
Figure 1.
Despite a Shrinking Population of Veterans, the Number of Veterans Who Use VA for Health Care Will Increase Until 2019, Then Level Off or Decline
Figure 2.
Figure 2.
VA Patients Have a Higher Prevalence of Serious Health Conditions Than Other Veterans and Non-Veterans
Figure 3.
Figure 3.
VA Patients Rely on VA for Only a Part of Their Health Care
Figure 4.
Figure 4.
As the Veteran Population Continues to Shift to the South and West, There Will Be Substantially Fewer Veterans in Some Areas in the Northeast and Upper Midwest
Figure 5.
Figure 5.
Nearly All Veterans Live Within a 40-Mile Drive to a VA Health Care Facility; Far Fewer Have Easy Access to VA Facilities Via Public Transit
Figure 6.
Figure 6.
Most Veterans Get Care Within Two Weeks of Their Desired Appointment Date
Figure 7.
Figure 7.
VA Outpatient Care Outperformed Non-VA Outpatient Care on Most Quality Measures; VA Performance on Measures of Inpatient Care Was Mixed, with Some Better and Others Worse
Figure 8.
Figure 8.
Cost and Demand for Purchased Care Have Increased Almost Three-Fold Over the Past Decade, and This Trend Will Likely Continue
Figure 9.
Figure 9.
VA Purchased Care Evolved in an Unsystematic Fashion

Source: PubMed

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