The Department of Veterans Affairs health care system received a highly favorable review in an interim report published December 2007 by the Congressional Budget Office (CBO). The report requested by several Congressional Committees reviewed the quality of the VA’s healthcare, looked at the achievements, and examined the lessons learned from management initiatives and using health IT systems.
VA’s accomplishments are very important since the agency finds increased demand for services. From 1999 through 2007, enrollment in the VA Healthcare systems swelled from over three million to nearly eight million veterans. The number of veteran patients treated each year increased from 3.2 million to more than five million.
The VA’s restructuring efforts now permits more shared decision making between VA’s central office, regional managers, and facility directors. The VA is able to measure performance, process and outcomes, along with the effectiveness of the system-wide health information technology used at the agency.
The CBO report pointed to VA’s structure as an integrated healthcare system that allows for two important tools:
- Incentives given to managers and providers to meet quality of care and practice guideline targets
- Health IT systems that provide reminders about tests and treatments recommended by the practice guidelines. Research shows that computer reminders and prompts can significantly improve adherence to clinical guidelines particularly for preventive care
To see the interim report, go to www.cbo.gov. The final report expected to be released in early 2008, will address the potential for other public and private healthcare systems to apply similar approaches and will also address other issues.