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Asst Dep Under Secretary for Health for Policy & Planning

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Planning

Enrollee Health Care Projection Model

The VA Enrollee Health Care Projection Model (Model) projects Veteran enrollment, health care utilization, and expenditures for 20 years into the future. The Model projects the number of Veterans expected to be enrolled in a geographic area, their total health care needs, and the portion of that care they are expected to receive in VA versus other health care providers. The expenditure projections that support the VA health care budget request are based on the anticipated costs associated with the projected utilization (not patients).

The Model accounts for the impact of the following on Veteran enrollment and use of VA health care services:

  • Enrollee age, gender, morbidity, and geographic migration patterns
  • Enrollee reliance on VA health care versus other health care providers
  • Enrollee income, local unemployment rates, and travel distance to VA facilities
  • Long-term downward trend in labor force participation
  • Enrollee transition between enrollment priorities, i.e., movement into service-connected priorities and transitions due to changes in income
  • Unique utilization patterns of the Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn, female, rural, and new enrollees, and specific age cohorts
  • New policies, regulations, and legislation and changes in the broader environment, such as the implementation of the Medicare drug benefit
  • VA health care initiatives, such as the mental health capacity improvement initiative
  • A continually evolving VA health care system, i.e., quality and efficiency initiatives
  • Future chnages in health care practice and technology