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Office of Budget

Fiscal Year 2005 Performance and Accountability Report
Published November 15, 2005

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Enabling Goal: Applying Sound Business Principles

Enabling Objective E-4: Sound Business Principles

Improve the overall governance and performance of VA by applying sound business principles; ensuring accountability; enhancing our management of resources through improved capital asset management, acquisition, and competitive sourcing; and linking strategic planning, budgeting, and performance planning.

Performance Trends and Impact of FY 2005 Result

Performance Trend FY 2005 Impact
Key Measure: Ratio of Collections to Billings
* Estimated actual. Final data are not yet available.
2001 31%
2002 37%
2003 41%
2004 41%
2005 Result 41%*
2005 Plan 41%
2006 Plan 41%
Strategic Target 41%
The 2005 projected result of a 41 percent ratio of collections to billings meets the target. This measure is commonly used in the private sector. VA's results appear comparatively lower than the private sector standard because VA cannot collect from Medicare, but must include 100 percent of charges to assert claims to the resulting Medicare supplemental carriers. By maximizing collections, more budget dollars can be allocated for improving the quality of care of veterans.

Related Information

Major Management Challenges

The following major management challenges have been identified for this strategic objective:

OIG
GAO
  • VA/DoD Efficiencies (more details)
  • Financial Management Weaknesses: Information Systems Security and Financial Management System Integration (more details)
  • VA/DoD Information Sharing (more details)
  • Federal Real Property: A High-Risk Area (more details)
  • Management of Interagency Contracting: A High-Risk Area (more details)

Program Evaluations

No independent program evaluations have been conducted that specifically address this objective.

Program Assessment Rating Tool (PART) Evaluation

In relation to this strategic objective, the Administration conducted a PART evaluation of VA's Medical Care program during 2003, which resulted in a rating of "Adequate." The Administration also conducted a PART evaluation of VA's General Administration program during 2004, which resulted in a rating of "Moderately Effective." Please see Summary Table 3 for more information

New Policies and Procedures

A standardized set of security policies and procedures templates, entitled "Facility Security Plan," were developed to assist facilities in implementing activities mandated for compliance with the HIPAA Security Rule. The policies cover the management, operational, and technical controls established by the National Institute of Standards and Technology for implementing an organizational-wide security framework.

The Office of the General Counsel (OGC) is partnering with VHA to improve the timeliness of medical reviews of medical malpractice tort claims. This should have a positive impact on the ability of OGC to resolve claims at the administrative level with greater accuracy. VA is requesting an increased delegation of settlement authority from the Department of Justice for settlement of tort claims, which will enhance OGC's capability to settle claims administratively.

Until such time as VA obtains legislative relief from the competitive sourcing prohibition of title 38, VA has moved forward employing a management analysis/business process reengineering initiative. The results of this analysis will be integrated into VA's workforce planning process. Pilots have begun with functional management teams studying the food services and laundry functions.

The Medical Materiel Management Work Group helped facilitate the joint purchasing of non-drug medical supplies and equipment. A plan was developed and implemented at the beginning of the year to track and monitor progress. A total of 23 DoD radiology contracts were modified so that VA could add unique VA terms to the contracts. DoD provided VA with copies of the contracts and pricing; by the end of the third quarter, 100 combined non-drug purchases were made totaling $47 million.

Following the full deployment of VA's Capital Asset Management System (CAMS) and the appointment of VISN Capital Asset Managers, the Office of Asset Enterprise Management provided training sessions covering federal real property policies and VA's capital asset management approach. Hands-on training focused on how to monitor asset performance and how to complete Web-based business case analysis applications (OMB Exhibit 300) in CAMS. The business case analysis applications are used to prioritize VA capital investments in meeting VA's strategic goals.

The Assistant Secretary for Management has delegated enhanced-use leasing authority to the Under Secretary for Health and, in some instances, to the capital asset manager assigned to a specific project. The delegation and training transfers full responsibility for the development, solicitation, and execution of enhanced-use lease transactions. It also streamlines and enhances the efficiency of pending and future enhanced-use lease projects.

VA awarded four indefinite delivery/indefinite quantity contracts to obtain a full range of expert developmental and transaction management support from service-disabled veteran-owned businesses on enhanced-use lease projects. The contract provides a sound and usable approach for effective, market-driven management of VA's capital investments. It standardizes and streamlines the Department's implementation of its enhanced-use lease authority and the CARES process.

Public Law 108-422 established the Capital Asset Fund (CAF) for VA in the Treasury of the United States. The revolving fund law grants the Secretary the authority to transfer, sell, or exchange real property to an appropriate party and deposit the funds into the CAF. Funds may be used for other disposals, minor medical projects with estimated costs of less than $7 million, or for historically designated projects. The goal of the CAF is to redirect funds currently spent on underutilized real property and reinvest them in additional health care services for veterans.

Quarterly Monthly Performance Review Reporting

Capital asset performance is now being reported quarterly at the Department's monthly performance review meetings. Reports will focus on Departmental performance in relation to Federal Real Property Council and Department of Energy measures. Performance exceptions will be highlighted for possible best practices or corrective actions.

Other Important Results

The VHA Chief Business Office wrote a white paper describing the benefits of electronic financial transactions for both the health plan and the health care provider communities. The white paper was used in discussions with industry policymakers and VHA business partners. The objective is to promote adoption of electronic financial transactions in the health care community.