Understanding Potential Changes to the Veterans Equitable Resource Allocation (VERA) System
Abstract
The Veterans Equitable Resource Allocation (VERA) system was instituted by the Veterans Health Administration (VERA) in 1997 in a continuing effort to improve the allocation of congressionally appropriated health care funds to the 21 Veterans Integrated Service Net- works (VISNs).1 VERA was designed to ensure that funds are allocated in an equitable, comprehensible, and efficient manner and to address the complexities of providing health care to veterans with service-connected disabilities, low incomes, and special health care needs. In contrast to earlier VHA allocation systems, which were based largely on historical costs, VERA bases its allocation of finds primarily on the number of veterans served (work- load). However, the veteran population has been shifting dramatically from some geographic areas to others. As a result, since the implementation of VERA, allocations to the VISNs have undergone similar shifts, from areas with shrinking veteran populations to areas with increasing numbers of veterans. These funding shifts prompted concerns in Congress that VERA was not distributing resources equitably across the VISNs, which could affect health care delivery to some veterans. In legislation enacted in late 2000 (Public Law No. 106-377), Congress directed the Department of Veterans Affairs (VA) to determine "whether VERA may lead to a distribution of finds that does not cover the special needs of some veterans. The VHA contracted with the RAND National Defense Research Institute to examine three specific areas of concern expressed by Congress: * The extent to which allocations cover costs associated with maintaining older-than- average medical facilities, caring for populations with complex case mixes, facilities undergoing major consolidation, and/or rural versus urban location. * Issues associated with maintaining affiliations between the VA medical centers and academic medical centers. The extent to which weather differences influence costs.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 01, 2004
- Accession Number
- ADA428630
Entities
People
- Barbara Wynn
- Jeanne Ringel
- Jeffrey Wasserman
- Jesse Malkin
- Karen Ricci
Organizations
- RAND Corporation