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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