Veterans Health Administration

1
DoD-VA
Partnership Status 1 September, 2005
2
DoD/VA Partnership

• How does MEPRS relate to this?
• Lets see

3
VA/DoD Executive Council Structure
Joint Executive Council (JEC)
Strategic Planning Committee
Construction Planning Committee
Health Executive Council (HEC)
Benefits Executive Council (BEC)
Work Groups and Task Forces
4
HEC Work Groups

• Contingency Response
• Deployment Health
• Evidence-Based Guidelines
• Financial Management
• Geriatric Care
• GME
• IM/IT
• Joint Facility Utilization
• Medical Education and Training
• Medical Material Management
• Patient Safety
• Pharmacy

5
Joint Strategic Plan

• Joint Strategic Plan Revised for FY2005
• Aligned and Tightened Objectives
• Performance Metrics
• Joint Strategic Plan objectives and measures
  tracked by the work groups
• Status Reported to the Councils
• Plan progress and revisions included in the
  annual report to the Secretaries and Congress

6
Joint Incentive Fund (JIF)
National Defense Authorization Act 2003, Section
721, authorizes DoD-VA Health Care Sharing
Incentive Fund

• Intent is to fund creative sharing initiatives at
  facility, regional and national levels
• VA will administer the fund under the HEC
• Minimum VA and DoD contributions are 15 million
  each from each Department between FY 2004 FY
  2007 (30M/year 120M total)
• GAO will review projects

7
JIF FY 2004 Process

• In FY 2004, 58 proposals initially submitted, 29
  proposals selected for further consideration, 12
  selected
• All projects received their first year funding
  (29.9M 7.5M required in year 2)
• Although some projects have had some delays, most
  are on track

8
Criteria for Proposals

• Improves access to beneficiaries
• Improves quality of care
• Number of beneficiaries impacted by initiative
• National, Regional or Local initiatives
• New initiative or sustain ongoing initiative
• Supports VA/DoD Joint Strategic Plan
• Develop in-house capability for services now
  obtained by contract
• Congruent with corporate direction
• Exportable to other facilities
• Positive Return on Investment
• Measurable Performance Data
• Project is sustainable after conclusion of JIF

9
Examples of Initiatives Submitted

• Shared MRI procurement and service
• Shared staffing
• Telemedicine Projects
• Cardiac Cath Lab
• Outpatient Clinics
• Sleep Studies
• Womens Health Clinics
• IM/IT Projects
• Research Not appropriate for JIF

10
JIF Results from FY 2004

• Federal Shared Third Party Obligation Program
  TMA and VACO
• Enhanced Outpatient Diagnostic Services VA
  Alaska Elmendorf AFB
• Expansion of MRI Services Dorn VAMC, Moncrief
  Army Community Hospital and Shaw AFB
• Joint Telemental Health System Fargo VAMC
  Grand Forks AFB
• Joint Dialysis Unit VA Northern California
  Travis AFB
• Mammography Services North Chicago VA Naval
  Hospital, Great Lakes

11
JIF Results from FY 2004

• Womens Health Clinic North Chicago VA Naval
  Hospital, Great Lakes
• Orthotics/Prosthetics VA Pacific Islands
  Tripler AMC
• Telepsychiatry Services Syracuse VAMC Ft.
  Drum
• North Central San Antonio Clinic South Texas
  HCS/Wilford Hall Medical Center
• Teleradiology VAMC Spokane Fairchild AFB
• Cardiac Catheterization Laboratory Dole VAMC
  McConnell AFB

12
JIF FY 2005

• Issued call for proposals November 2, 2004 due
  January 12, 2005
• Financial Mgt Working Group scored round one in
  February and March
• Projects selected to continue will submit
  financial analysis format and certification by
  resource managers
• Financial analysis format was provided
• Final submissions under review

13
Lessons Learned

• DoD experienced delay in fund allocation sites
  due to problems setting up new accounts and
  establishing new processes now resolved
• Sites should begin recruitment of professional
  staff as early as possible
• Sites attempting to hire Radiologists should
  anticipate higher costs
• Details of operations need to be developed early
  in the process document in Memorandums of
  Understanding
• Cost increases between proposal submission and
  award creates need to establish process to
  increase funding for sites where original
  estimates were insufficient

14
Demonstration Projects

• Eight Projects
• Budget and Financial Management 2
• Staffing and Assignment 2
• Medical Information/Information Technology 4
• Oct 2004 Through October 2007
• Evaluated by GAO
• Status Satisfactory
• Projects overseen by joint work group
• Progress tracked/reported monthly
• Developing lessons learned for exportability
• Forum is in E-Room

15
Great Lakes/North Chicago

• MILCON project to replace NH Great Lakes in 2007
• Joint Task Force recommended jointly managed
  facility
• Health Executive Council direction
• Different approach
• Reduce cost
• Increased integration over previous joint
  ventures
• Reduction of duplicative staff
• Incorporate lessons learned form demonstration
  sties
• Decision Fully Integrated Federal Medical Center
  

16
How does MEPRS relate to this?

• MEPRS data quality is critical to Program
  Management
• Articulating to Congress, GAO, OMB true cost
  benefit of sharing Fact vs Myth
• Rate setting/Budget precision
• Future?
• CARES
• BRAC
• Questions?