The Veteran’s Health Administration has been praised for its ability to deliver high-quality healthcare while controlling costs in part through the use of electronic medical records.
The Congressional Budget Office has released an analysis titled Quality Initiatives Undertaken by the Veteran’s Health Administration, which offers some interesting thoughts on the topic. (Note: VistA is VHA’s healthcare information technology system, which includes an EMR).
Some proponents of the veterans’ health system have suggested that VistA has helped the Veterans Health Administration hold down cost growth when compared with other federal health programs, such as Medicare. But such comparisons are difficult to make. The substantial changes in VHA’s structure and in eligibility for care make it particularly difficult to interpret such metrics as cost per enrollee when enrollment was rising dramatically from 1999 through 2002….(CBO) adjusted enrollment data to account for changes in the mix of enrollees and found that VHA’s spending per enrollee was relatively flat from 1999 through 2002, but since that date it has risen about as rapidly as spending per enrollee in the Medicare program. It is likely that rapid increases in annual appropriations for VHA, efforts to reduce waiting lists within the system, and expansion of mental health and other specialized services have contributed to the recent growth in spending per enrollee.
Here are some other interesting bits of information from the study.
Did you know?…Of the 8 million VHA enrollees, 31% also have private health insurance (79% have some type of non-VHA coverage, e.g., private, Medicare, Medicaid, Medigap or Tricare).
Did you know?…VistA source code is available free from VHA. Healthcare organizations must pay any adaptation, installation and training costs, which can be considerable. But the software is proven. Just ask Midland Hospital (Midland, TX).
Did you know?…Along with VistA, other factors in VHA’s dramatic improvement in quality included implementation of an external peer review program, performance incentives, and “the reorganization of VHA from a centralized system to a set of regional networks funded on a capitated basis—that is, based on the number and type of patients each network serves, rather than on the number of medical procedures performed or on historical budgets.”
Did you know?…VHA’s integrated delivery system includes 150 medical centers, 900+ outpatient clinics, and facilities for counseling and long-term care. In 2008, VHA treated 5.1 million or 22% of the nation’s veterans, at a cost topping $40 billion.