Summary: Pursuant to a congressional request, GAO reviewed several options to achieve budgetary savings in the Department of Veterans Affairs' (VA) health care system without adversely affecting the current level of services provided to low-income or disabled veterans. GAO noted that VA could achieve health care cost savings by: (1) shifting care from VA hospitals to alternative settings such as ambulatory care; (2) adopting state veterans' home charging policies; (3) authorizing estate recovery programs; (4) increasing copayments for health services; (5) reducing or eliminating care for veterans with high incomes; (6) delaying VA hospital construction projects; (7) increasing the use of community nursing homes as an alternative to new VA nursing homes; (8) strengthening veterans' income verification requirements; (9) changing VA dispensing practices for prescription drugs; (10) eliminating the dispensing of over-the-counter drugs; (11) recovering the full costs of services provided to nonveterans; (12) consolidating its mail service pharmacies; (13) consolidating underutilized services in nearby VA medical centers; (14) suspending locality-based pay adjustments; and (15) restructuring its ambulatory care system.