Integrating Department of Defense and Department of Veterans Affairs Purchased Care: Preliminary Feasibility Assessment

Abstract

The U.S. Department of Defense (DoD) and U.S. Department of Veterans Affairs (VA) are responsible for providing health care to eligible veterans, current and retired service members, and military dependents. DoD (through the TRICARE program) and VA (through the Veterans Health Administration, or VHA) provide a mix of care that is delivered at government-owned and -managed medical facilities (direct care) and through private-sector contracts (purchased care).Through these purchased care contracts, third-party administrators (TPAs) coordinate and administer payments to community-based providers for delivering health care services to TRICARE beneficiaries or VHA enrollees. In the interest of expanding DoD-VA sharing, the DoD/VA Joint Executive Committee is exploring options to integrate DoD and VAs purchased care approaches (including contracting functions and provider networks) and asked the RAND Corporation to conduct a preliminary feasibility assessment of an integrated approach to purchasing care for the two departments. To conduct the feasibility assessment, RAND reviewed relevant laws, regulations, and published literature; interviewed DoD and VA decisionmakers, congressional staff, and other stakeholders; and analyzed DoD and VA data on purchased care utilization and current TPA provider networks. This report describes the DoD and VA health care systems and current mechanisms for purchasing care, potential opportunities for joint purchasing of private care, and the legislative, policy, and operational challenges for integrating DoD and VAs approaches to purchasing care. The report also provides a cursory examination of the potential impact of an integrated purchased care contract on access, quality, and costs for beneficiaries and DoD/VA health systems.

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Document Details

Document Type
Technical Report
Publication Date
Jan 01, 2018
Accession Number
AD1086474

Entities

People

  • Ammarah Mahmud
  • Carrie M. Farmer
  • Christine Buttorff
  • Christopher Whaley
  • Erin L. Duffy
  • Lauren Skrabala
  • Lisa H. Jaycox
  • Nicholas M. Pace
  • Phillip Carter
  • Samantha Cherney
  • Susan D. Hosek
  • Terri Tanielian

Organizations

  • RAND Corporation

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Congress
  • Delivery Of Health Care
  • Employment
  • Geographic Regions
  • Health Services
  • Information Systems
  • Law
  • Medical Personnel
  • Military Hospitals
  • Military Medicine
  • Military Personnel
  • National Security
  • Personnel Management
  • Physicians

Fields of Study

  • Medicine
  • Political science

Readers

  • Government Contracting/Procurement.
  • Medical or Health Care Field.
  • Rehabilitation and Prosthetic Care for Military Service Members and Veterans with Limb Loss or Disability.