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 1999-04-15 monographic deposited born digital 25 p. GA 1.13:T-HEHS-99-109 https://www.govinfo.gov/app/details/GAOREPORTS-T-HEHS-99-109 P0b002ee180399923 f:he99109t DGPO 2010-08-12 2011-03-24 GAOREPORTS-T-HEHS-99-109 machine generated eng fdlp REPORT GAOREPORTS-T-HEHS-99-109 T-HEHS-99-109 Veterans benefits Reductions in force Health care cost control Health services administration Veterans hospitals Presidential budgets Federal downsizing Federal agency reorganization Health resources utilization VA Medical Care Collections Fund VA Capital Asset Fund VA Medical Education Program Medicare Trust Fund Other Written Product HEHS Pursuant to a congressional request, GAO discussed the challenges facing the Department of Veterans Affairs (VA) in transforming health care, focusing on: (1) VA's transformation progress to date; (2) challenges that remain to be confronted; and (3) the implications for VA's fiscal year (FY) 2000 budget. GAO noted that: (1) VA's transformation continues to make significant progress; (2) over the last 3 years, VA has enhanced benefits and served 400,000 additional veterans, while realizing a non-appropriated revenue surplus of $496 million that remains available for future use; (3) this was accomplished primarily because VA's management initiatives reduced operating costs by over $1 billion; (4) the most notable initiatives involved shifting veterans' care to appropriate settings and reengineering administrative and clinical processes; (5) this year, however, GAO's work shows that VA's transformation appears to be losing momentum; (6) VA, for example, has prolonged decisions concerning much needed restructuring of aged capital assets, including hospital closures, which could result in unnecessary expenditures of billions of dollars over the next several years; (7) VA's transformation cannot be successfully completed until these and other critical challenges are adequately addressed; (8) in GAO's view, VA's FY 2000 budget is based on the unduly optimistic expectation that its ongoing transformation will generate needed efficiencies of $1.4 billion in savings; (9) VA assumes that employment reductions in FY 2000 will be more than 3 times greater than expected FY 1999 reductions; (10) VA has not taken the underlying management actions--such as aggressively addressing all potential facility integrations and service consolidations--that appear necessary to make a three-fold reduction possible; (11) if VA had made such difficult decisions earlier, it might not need to realize this level of savings; (12) moreover, VA may ultimately need to use less desirable management actions, including large-scale employee furloughs, to operate within its proposed budget; (13) such actions could adversely affect all veterans' quality of care, especially waiting times; and (14) VA could avoid such undesirable outcomes for higher priority veterans if, as Congress intended, VA uses its new enrollment process to manage access to VA health care services within available resources. https://www.govinfo.gov/content/pkg/GAOREPORTS-T-HEHS-99-109/html/GAOREPORTS-T-HEHS-99-109.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-T-HEHS-99-109/pdf/GAOREPORTS-T-HEHS-99-109.pdf GAO/T-HEHS-99-109 https://www.govinfo.gov/app/details/GAOREPORTS-T-HEHS-99-109 Other Written Product GAO/T-HEHS-99-109; Veterans' Affairs: Progress and Challenges in Transforming; Veterans benefits Reductions in force Health care cost control Health services administration Veterans hospitals Presidential budgets Federal downsizing Federal agency reorganization Health resources utilization VA Medical Care Collections Fund VA Capital Asset Fund VA Medical Education Program Medicare Trust Fund