United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Health, Education, and Human Services Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 1997-07-17 monographic deposited born digital 36 p. GA 1.13:HEHS-97-87 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-97-87 P0b002ee180381926 f:he97087 DGPO 2010-08-12 2011-03-28 GAOREPORTS-HEHS-97-87 machine generated eng fdlp REPORT GAOREPORTS-HEHS-97-87 HEHS-97-87 Physicians Health maintenance organizations Managed health care Veterans benefits Health care services Productivity Health centers Health resources utilization Health services administration VA Decision Support System VA Veterans Equitable Resource Allocation System VA Resource Allocation Methodology System VA Resource Planning and Management System Letter Report HEHS Pursuant to a congressional request, GAO provided information on what the Department of Veterans Affairs (VA) is doing to manage its physician resources as well as how health maintenance organizations (HMO) manage their physician resources.<p/>GAO noted that: (1) VA is in the midst of making fundamental changes in its health care delivery system because of budgetary pressures and increasing competition in the health care industry; (2) many of these initiatives are affecting the entire VA health care delivery system; they will also affect how VA manages physician resources, including identifying the appropriate number and skill mix of physicians and monitoring productivity and quality of care provided; (3) these initiatives involve changes in physician practice patterns and in resource allocation to help ensure effectiveness and efficiency; (4) VA is changing physician monitoring by emphasizing standardized productivity and clinical care outcome measures, which are increasingly being used in the private sector to monitor the efficiency and effectiveness of physician performance; (5) in addition, further embracing private sector managed care practicers, VA is changing the way physicians practice by assigning veterans to a primary care physician, an approach that emphasizes continuity of care, prevention, and the early diagnosis of disease and allows VA to better attribute clinical care outcomes to specific provider performance; (6) VA expects to change physician practice patterns and improve service delivery efficiencies by distributing health care funding on the basis of workload rather than according to historic funding patterns, which perpetuated imbalances in funding, efficiency, and access to care throughout the VA health care system; (7) VA has not developed a staffing and resource allocation model that identifies optimal physician staffing levels or the skill mix of physicians needed to provide health care to eligible veterans, and no agreed-upon physician workload standards exist either in the private sector or at VA for most physician specialties, including primary care; (8) VA faces unique challenges in managing its physician resources; (9) it must balance multiple congressionally mandated missions, such as training health care professionals, that reduce physicians' clinical care productivity relative to that of physicians in private sector HMOs; (10) in addition, VA performance measurement and allocation systems are hampered by incomplete and inaccurate data; and (11) moreover, accurate estimates of workload, and essential element of resource allocation, are particularly challenging with a patient population that is sicker and o* https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-97-87/html/GAOREPORTS-HEHS-97-87.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-97-87/pdf/GAOREPORTS-HEHS-97-87.pdf GAO/HEHS-97-87 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-97-87 Letter Report GAO/HEHS-97-87; VA Health Care: VA Is Adopting Managed Care Practices to Better Manage Physician Resources; Physicians Health maintenance organizations Managed health care Veterans benefits Health care services Productivity Health centers Health resources utilization Health services administration VA Decision Support System VA Veterans Equitable Resource Allocation System VA Resource Allocation Methodology System VA Resource Planning and Management System Public Law 104-262