VA Health Care

The Department of Veterans Affairs (VA) is integrating its medical facilities in Tuskegee and Montgomery, Alabama. The two facilities' managerial, clinical, and patient support services are to be restructured into a single health care delivery system called the Central Alabama Veterans Health Care System, which is intended to provide the same or higher quality services at lower cost. GAO testified that VA officials have made significant progress in planning for this integration, and benefits have already been realized. Planning activities, however, have yet to be completed, including (1) key decisions on whether and how to restructure services, such as nutrition and food services; (2) assessments of the probable impact of clinical, administrative, and patient support service changes on veterans and employees; and (3) determinations of how savings will be reinvested to benefit veterans. Moreover, some stakeholders have found it difficult, if not impossible, to assess the reasonableness of VA's decisions and to ultimately "buy in" to them without the benefit of information from completed planning activities facilitywide. VA needs to complete its planning in sufficient detail to ensure that benefits are maximized and adverse impacts minimized. impacts minimized.

GAO noted that: (1) on the basis of GAO's work to date, it appears that both Atlanta network and Montgomery and Tuskegee facility officials have made a lot of progress in planning for this integration, and benefits have already been realized; (2) planning activities, however, are yet to be completed, including: (a) making key decisions on whether and how to restructure certain services, such as nutrition and food services; (b) fully assessing the probable impact of clinical, administrative, and patient support service changes on veterans and employees; and (c) determining how savings will be reinvested to benefit veterans; (3) moreover, some stakeholders have found it difficult, if not impossible, to assess the reasonableness of VA's decisions and to ultimately buy in to them without the benefit of information from completed planning activities facilitywide; and (4) because integrating facilities involves inherently difficult issues and requires careful planning, it seems important for VA to complete its planning in sufficient detail to ensure that benefits are maximized and adverse impacts minimized.