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dc.contributor.authorFulton, Lawrence V. ( Orcid Icon 0000-0001-8603-1913 )
dc.contributor.authorBrooks, Matthew ( Orcid Icon 0000-0001-6064-1545 )
dc.date.accessioned2019-08-20T20:43:56Z
dc.date.available2019-08-20T20:43:56Z
dc.date.issued2018-08
dc.identifier.citationFulton, L. V., & Brooks, M. S. (2018). An Evaluation of Alternatives for Providing Care to Veterans. Healthcare, 6(3): 92.en_US
dc.identifier.issn2227-9032
dc.identifier.urihttps://digital.library.txstate.edu/handle/10877/8532
dc.description.abstractIn 2014, a whistleblower reported that many U.S. veterans died while waiting for care at the Phoenix VHA. Problems with veteran’s care through 2018 reveal ongoing and systematic problem. In March 2018, the VA Inspector General identified critical deficiencies at the Washington, DC VA Medical Center including failures to track patient safety events accurately, ineffective sterile processing and more than 10 thousand open or pending prosthetic/sensory aid consults. The VHA clearly has problems with access and quality in a budget-constrained environment. In this policy analysis, four separate interventions that address the gap between the magnitude as well as the use of the VHA’s fixed budget versus access and cost expectations are explored. These policy interventions include maintaining the status quo, returning to a “VHA-only” option, transitioning to a CMS central payer system and consolidating care under the DoD TRICARE insurance plans. An objective evaluation suggests that extending TRICARE to veterans during the phasing out the VHA’s care responsibilities, while politically unpalatable, would likely provide the best of four possible solutions under various criterion weighting schemes. A central payer solution under the CMS would also be a viable consideration. Results suggest that TRICARE patient perceptions of quality are superior to VHA and non-VHA/non-DoD, that access provided by the TRICARE program is ranked second in terms of venue acceptance only to the CMS solution set based on primary provider acceptance and that the cost per beneficiary of a TRICARE solution ($6.5 K/beneficiary) is far better than a VHA-only solution ($14.0 K/beneficiary), the CMS central payer solution ($12.2 K/beneficiary), or the status quo (between $12.2 K and $14.0 K/beneficiary). The intent of this paper is to provoke thoughtful consideration of solutions for providing access to high-quality healthcare for veterans within or outside of the VHA.en_US
dc.formatText
dc.format.extent14 pages
dc.format.medium1 file (.pdf)
dc.language.isoen
dc.publisherMultidisciplinary Digital Publishing Instituteen_US
dc.sourceHealthcare, 2018, Vol. 6, No. 3, Article 92.
dc.subjectVHA
dc.subjectVA
dc.subjectCMS TRICARE
dc.subjectScandal
dc.subjectHealth policyen_US
dc.titleAn Evaluation of Alternatives for Providing Care to Veteransen_US
dc.typepublishedVersion
txstate.documenttypeArticle
dc.rights.holder© 2018 The Authors.
dc.identifier.doihttps://doi.org/10.3390/healthcare6030092
dc.rights.licenseCreative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
txstate.departmentHealth Administration


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