全球智库信息集成服务系统

Key Findings

1. An integrated approach to purchasing care in DoD and VA would be legally permissible under existing authorities, but appropriations language would need to change.
2. In recent years, there have been significant changes to how DoD and VA manage health care, in addition to new policies affecting the U.S. health care system in general. Any decisions must consider how this evolving policy context will affect the feasibility and effectiveness of an integrated purchased care approach.
3. The benefits of an integrated purchased care approach in terms of patient experience, provider availability, cost savings, and operational efficiencies are uncertain but may be limited.

The U.S. Department of Defense (DoD) and U.S. Department of Veterans Affairs (VA) health systems are each responsible for providing health care to more than 9 million eligible beneficiaries, with some overlap between their populations. Both systems provide services through a mix of direct care, delivered at government-owned and -managed facilities, and purchased care, provided through the private sector, mainly by community-based providers who have entered into contracts with third-party administrators (TPAs). TPAs coordinate and administer reimbursements to network providers on behalf of DoD and VA for delivering health care services to eligible beneficiaries.