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 1999-09-23 monographic deposited born digital 14 p. GA 1.13:T-HEHS-99-196 https://www.govinfo.gov/app/details/GAOREPORTS-T-HEHS-99-196 P0b002ee180388aee f:he99196t DGPO 2010-08-12 2011-03-24 GAOREPORTS-T-HEHS-99-196 machine generated eng fdlp REPORT GAOREPORTS-T-HEHS-99-196 T-HEHS-99-196 Insurance companies Government collections Claims processing Managed health care Patient care services Health care programs Health insurance cost control Cost sharing (finance) Veterans benefits Medicare Program VA Medical Care Collections Fund Testimony HEHS Pursuant to a congressional request, GAO discussed the Department of Veterans Affairs' (VA) efforts to increase revenues from alternative sources as a way to supplement its medical care appropriations, focusing on trends in third-party collections.<p/>GAO noted that: (1) VA's third-party collections have declined in each of the past 3 fiscal years and may decline again by the end of fiscal year (FY) 1999; (2) in FY 1998, VA collected $442 million from third-party insurers for care provided to veterans for non-service-connected conditions, down from $523 million in FY 1995; (3) in FY 1999, as of August 31, VA had collected about $388 million from third-party insurers; (4) unless VA's September collections exceed by $19 million its average monthly collections of $35 million, the annual decline in third-party collections will continue for the fourth year in a row; (5) next fiscal year, VA will experience its first full year of billing insurers on a reasonable-charges basis rather than a reasonable-cost basis; (6) however, data are insufficient to predict whether this will reverse the declining collections trend; (7) VA has tried to reverse the decline in its collections from third-party insurers; (8) three factors limit VA's ability to increase the amount it collects from private insurers--the increasing number of veterans whose primary insurance is Medicare, increasing health maintenance organization penetration, and its own efforts to increase the emphasis on outpatient care; (9) nevertheless, VA can enhance its chances of increasing collections if it ensures that the management improvements that are being implemented at some facilities are implemented throughout VA; and (10) these include overall improvements in VA medical facilities' use of good business management practices, as well as specific improvements in how facilities collect insurance information, document the appropriateness and medical necessity of care being billed, and pursue unpaid bills. https://www.govinfo.gov/content/pkg/GAOREPORTS-T-HEHS-99-196/html/GAOREPORTS-T-HEHS-99-196.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-T-HEHS-99-196/pdf/GAOREPORTS-T-HEHS-99-196.pdf GAO/T-HEHS-99-196 https://www.govinfo.gov/app/details/GAOREPORTS-T-HEHS-99-196 Testimony GAO/T-HEHS-99-196; VA Health Care: Collections Fall Short of Expectations; Insurance companies Government collections Claims processing Managed health care Patient care services Health care programs Health insurance cost control Cost sharing (finance) Veterans benefits Medicare Program VA Medical Care Collections Fund