Tag Archives: Veteran’s Administration

Military healthcare costs up

USA Today published a column today looking at the growing cost of healthcare for military personel. Here is an excerpt:

Military health care spending is rising twice as fast as the nation’s overall health care costs, consuming a larger chunk of the defense budget as the Pentagon struggles to pay for two wars, military budget figures show. The surging costs are prompting the Pentagon and Congress to consider the first hike in out-of-pocket fees for military retirees and some active-duty families in 15 years, said Rear Adm. Christine Hunter, deputy director of TRICARE, the military health care program.

Pentagon spending on health care has increased from $19 billion in 2001 to a projected $50.7 billion in 2011, a 167% increase.

The rapid rise has been driven by a surge in mental health and physical problems for troops who have deployed to war multiple times and by a flood of career military retirees fleeing less-generous civilian health programs, Hunter said.

 The question of cost-sharing is faced by various other kinds of health plans. Here is information on cost sharing patterns we have seen in employer health plans.

EHR and fighter jets

Here’s one to ponder: How is the electronic health record (EHR) system used by the Department of Veterans Affairs similar to a fighter jet? This article from Federal Computer Week plays out the comparison:

Dr. Steve Ondra, senior policy adviser for health affairs at the VA, was talking about the development and modernization of legacy electronic health record systems at the department, including VistA, and how those systems eventually will synchronize with new record programs, such as the VA/Defense Department Virtual Lifetime Electronic Record.

He compared the evolution of VistA to the VLER, as being comparable to the evolution of World War II-era planes into modern fighter jets. The comparison became more complex as it went along.

To illustrate his point, Ondra said the VA started out with electronic record systems comparable to a P-51 Mustang, a World War II-era fighter plane, and to a Sabre Jet, which dates from the Korean War.

“The Sabre is a good jet, but a little dated,” Ondra said, apparently still talking about the VA’s legacy systems such as VistA.

The next step, which includes creating the VLER, aims to be upgrade the legacy VA systems to make them comparable to an F-15 or F-22 modern fighter jet, Ondra added.

Grab bag

Lots of reading to catch up on:

VA Secretary Shinseki discusses budget projections

The Honorable Erik Shinseki, Veterans Affairs Secretary, testified today before Congress on the VA’s appropriations process, specifically citing Milliman’s role in this process. As you might expect, a relatively accurate advanced budgeting capability is crucial to the mission of an organization like the VA, which has so many patients and such a large and sophisticated organization.

Here is an excerpt from the Secretary’s testimony:

Implementing an advance funding mechanism is not without challenges and careful planning is needed to ensure timely funding without unintended consequences. Budget projections are rarely right on the mark, and the further out they are made, the farther off the mark they are likely to be.  For an advance appropriations mechanism to function effectively, it must be linked to a forecasting model that is both reliable and accurate, to the extent possible. Today I will concentrate on VA’s principal forecasting model — the Enrollee Health-Care Projection Model.

The Enrollee Health-Care Projection Model, or VA Model, is a comprehensive enrollment, utilization, and expenditure projection model.  It was originally developed in 1998 in partnership with Milliman, Inc., the largest actuarial firm in the country. Through the past 11 years of periodic updates and continuous refinement, VA and Milliman have developed a strong partnership that has resulted in a powerful modeling tool. VA guides the overall development of the VA Model and ensures that it meets the needs of stakeholders. VA program staff provide expertise on the unique needs of Veterans, patterns of practice in the VA health-care system, and how the system is expected to evolve over the next 20 years. Milliman brings specialized expertise, access to extensive amounts of health-care utilization data VA, and excellent research to the overall modeling effort.

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Veterans Administration builds on electronic record system

President Obama today announced an effort to computerize the medical records of all military personnel and better integrate records between the Defense Department and the Department of Veterans Affairs. This is a complicated issue, as was made apparent during tonight’s PBS coverage of the announcement:

The proposal builds off of an existing infrastructure. The VA has a robust electronic health record system in place already, as Gail Graham discussed at the EHR Town Hall in December:

Do providers face an electronic health record learning curve? (Part II)

Ron Sims, Rich Moyer, Gail Graham, and Scott Armstrong continue to respond to Wednesday’s question about adoption of electronic health records.


Ron Sims: The original question was, “Who is going to come with the standards?” And I believe you’re going to see the Federal Government move on them with a great deal of aggression over the next couple of years, and there’s several reasons why. If you look at the issues that the three car companies face, one of the things that they’ve been raising on a pretty consistent basis is their healthcare costs, not only their pension costs, but their healthcare costs.

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