Revamping VA care: Efforts to improve efficiency may have backfired

Measures intended to make the military's health care system for severely wounded servicemembers more efficient may have caused duplication, confusion, and inefficiencies, the Washington Post reports.

In 2007, a nine-member presidential commission led by former Sen. Bob Dole (R-Kan.) and University of Miami President and former HHS Secretary Donna Shalala issued a 29-page report urging "fundamental changes" to military and veterans' health care programs. The panel issued six steps to improve care.

According to the Post, the changes to military health programs—which were intended to improve health care delivery—have had the "opposite effect," said Debra Draper, health care director for the Government Accountability Office. The numerous options can bring additional paperwork and conflicting treatment rules, as well as numerous case managers overseeing care for one patient.

A RAND study released last week found that the U.S. military provides 211 programs to prevent, identify, and treat brain injuries and psychological issues, such as post-traumatic stress disorder. The Pentagon-commissioned report found that some of the programs have been duplicated and created "a high risk of a poor investment" in defense spending.

The Department of Defense (DOD) has defended its programs. Philip Burdette, DOD's director of wounded-warrior care, said the agency built an "intentional safety net" to cover all military personnel. However, the Post notes that Pentagon officials consider veterans active military personnel health care separately. As a result, there also is no database tracking all wounded military personnel, making it difficult to know who is getting federal assistance (Vogel, Post, 11/18).

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