Strategic Goal: Provide One VA world-class service to veterans and their families through the effective management of people, technology, processes, and financial resources. VA will operate as a veteran-focused organization that provides high quality, accessible, and timely information and service through the development and maintenance of a high-performing workforce, the application of state-of-the-art technologies, the continuous improvement of processes, and the effective allocation of dollars.

Objective: Improve VA’s overall governance and operational management, and access to benefits and services to meet or exceed the expectations of veterans and their families, while ensuring full compliance with applicable laws, regulations, and financial commitments.

Performance Goal: All alternative revenues, including medical recoveries, Medicare and other sharing revenues, will total 3 percent of the Medical Care operating budget.

As part of a three-ply approach to becoming more efficient, VA has for several years attempted to diversify its funding base and increase the percent of health care funds from alternative revenue streams through medical cost recoveries, sharing revenues and Medicare reimbursements. Therefore, prior to developing the FY 2002 Performance Plan, we will reevaluate the appropriateness of maintaining this as one of the Department’s key measures.

The future success of the VA health care system may depend as much on diversifying our funding base as on any other strategy. VA will actively pursue alternative revenue streams including medical cost recoveries and a Medicare reimbursement pilot, that is, Medicare subvention, based on the evaluation of DoD subvention due to end in December 2000.

A variety of strategies will be used to maximize the share of the medical care operating budget derived from alternative revenue streams.

• Implementation of reasonable charges, accomplished in September 1999, allows for market price recoveries for actual services provided.
• To ensure accurate insurance information, all medical facilities are establishing patient pre-registration, to include the use of software that assists in gathering and updating patient insurance information.
• Outsourcing opportunities for all or part of the revenue process are being pursued.
• Scanning outpatient encounter forms and using outpatient procedure rates will increase outpatient recoveries.

VA continues to work with the Health Care Financing Administration to obtain Congressional authorization for Medicare subvention.

There are no major management challenges that will affect achievement of this performance goal.

The source for these data is the general ledger maintained by VHA Financial Management and the Automated Allotment Control System. The numerator for this goal is revenues from each VISN’s general ledger. The denominator is all VISN allocations (including prorated share of national specific programs) based on total VHA obligations. A VISN-specific report is produced annually. Although the goal has been 10 percent, numerous factors have contributed to this goal not being met.

(For additional information on this performance goal, refer to Medical Programs, Volume 2, Chapter 2.)