By Jeffrey Wasserman, Jeanne Ringel, Barbara Wynn, Jack Zwanziger, Karen Ricci
This ebook is in line with the hot laws (H.R. 4635), the U.S. Congress requested the DVA to behavior a learn on no matter if VERA adquately meets the distinctive wishes of a few veterans. Rand was once requested to adopt this learn. The findings and proposals are documented during this record.
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Additional info for An Analysis of the Veterans Equitable Resource Allocation (VERA) System
As a result, the distribution of funding across VISNs would be quite different under each method. Consequently, while most people that we spoke with would agree that the current case-mix adjustment should be refined, no general consensus emerged on exactly how it should be refined. If the case-mix adjustment does not adequately account for differences in the average health status of veterans across VISNs, the system may contribute to inequities in access to care across networks. A VISN with a particularly difficult case mix may not be funded adequately to provide the care their patients need.
Interviews with staff at many networks with strong medical school affiliations revealed resistance on the part of the medical schools to move from an inpatient specialty model of graduate medical education to an outpatient primary care model. Thus, closing inpatient facilities and consolidating services creates tension between the VHA and their medical school affiliates. As a result of the barriers to consolidation, many VISNs are in a difficult situation. The allocation methodology rewards cost efficiency and thus encourages VISNs to take actions to reduce costs.
In one VISN, staff reported that the workload was “crushing” and that all CBOC appointments are filled within a day or two of opening. Detrimental Impacts of VERA on Access While the incentive under the VERA methodology to increase workload has beneficial impacts on access to care, the method used to predict workload has had an opposing effect. Although different methodologies are used to forecast workload for Basic and Complex Care patients, neither fully reflects recent growth in the number of patients served.
An Analysis of the Veterans Equitable Resource Allocation (VERA) System by Jeffrey Wasserman, Jeanne Ringel, Barbara Wynn, Jack Zwanziger, Karen Ricci