Unbiased Analysis of Today's Healthcare Issues

Non-VA VA Care

Written By: Jason Shafrin - Jun• 01•10

Veterans Affairs is is responsible for administering programs of veterans’ benefits for veterans, their families, and survivors.  In 2009, the VA had a budget of $87.6 billion and employed nearly 280,000 people at hundreds of Veterans Affairs medical facilities, clinics, and benefits offices.

The VA is often held up a the model for integrated care. Physicians work on a salaried basis.  Patient generally only receive treatment from VA facilities.

Sometimes, however, the VA is not able to provide care in house.  In this case, the Non-VA Purchased Care Program fills this void. The Purchase Care Program supplements rather than replaces the standard VA health care.  Reasons why beneficiaries would access the Purchased Care Program include:

  • Beneficiaries not able to access VA health care facilities
  • Demand exceeds VA health care facility capacity
  • Need for diagnostic support services for VA clinicians
  • Need for scarce specialty resources (e.g., obstetrics, hyperbaric, burn care, oncology) and/or when VA resources are not available due to constraints (e.g. staffing, space)
  • Satisfying patient wait-time requirements
  • Ensure cost-effectiveness for VA (whereby outside procurement vs. maintaining and operating like services in VA facilities and/or infrequent use is more appropriate)

The Purchased Care Program has expanded over the years.  In fiscal year 2005, the PCP program served about 500,000 veterans and had program expenses of $1.5 billion.  By FY2008, the program served almost 800,000 veterans had had expenses of over $3 billion.   FY08 expenses include:

  • 35% for pre-authorized outpatient care,
  • 22% for pre-authorized inpatient care,
  • 14% for community nursing home services,
  • 12% for home health services,
  • 9% for military care,
  • 5% for unauthorized care, and
  • 3%  for other services.

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