The VA and DOD do not require that all collaboration sites — locations where the two departments share healthcare resources — develop and use performance measures to assess the departments’ effectiveness and efficiency. This is because they do not want to overburden sites with measures and monitoring requirements; however, without comprehensive performance measures, the sites lack information for decision-making and overall progress in meeting goals for improved healthcare access, quality and costs, according to the report.
GAO identified four areas of incompatible policies and practices:
• Information technology —The VA and DOD collect, store and process health information in different IT systems, making access to information needed to best treat patients problematic.
• Business and administrative processes — Different billing practices, difficulties capturing patient workload information and overlapping efforts in credentialing providers and computer security training reduce efficiency.
• Access to military bases — Balancing base security needs with veterans’ needs to access medical facilities creates difficulties.
• Medical facility construction — Misaligned construction planning processes hinder efforts to jointly plan facilities to serve both VA and DOD beneficiaries.
According to the report, the departments need to develop a process for systematically identifying and selecting collaboration opportunities or risk missing opportunities to achieve shared goals and reduce duplication of services.
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