VA Health Care

Since its creation in 1930, the Department of Veterans Affairs' (VA) health care system has become one of the nation's largest networks of direct delivery health care providers, with 173 hospitals and 376 outpatient clinics nationwide. But because public and private health insurance programs have also grown, most veterans now have alternatives to VA health care. Many veterans indicate that they use private providers because they live too far from VA hospitals or outpatient clinics. VA has recently encouraged its facilities to improve veterans' access to VA health care. This report discusses (1) characteristics of recent users of VA medical facilities; (2) the geographic accessibility of VA and private medical facilities that provide standard benefits; and (3) options that VA facilities might want to consider to improve the accessibility of VA health care, such as locating new medical facilities closer to where veterans live and contracting with private providers.

GAO found that: (1) in the early 1990s, over 80 percent of veterans who received health care services obtained them from non-VA sources; (2) veterans who used VA medical facilities generally had lower incomes and were less likely to have private health insurance than veterans who obtained health care from non-VA facilities: (3) veterans with service-connected disabilities utilized VA facilities more often than other veterans; (4) about 50 percent of all veterans lived over 25 miles from a VA facility and 11 percent of veterans lived within 5 miles of a VA hospital; (5) although VA hospitals and outpatient clinics were geographically less accessible to veterans than private medical facilities, veterans had better access to certain specialty services through VA facilities; (6) options to improve veterans' access to VA health care include determining whether to improve access for current users, all veterans, or selected veterans groups, and comparing the costs of VA-provided services and contractor-provided services; and (7) although VA facilities are more costly to operate, they lessen the chances of program abuse by giving VA more control over resources.