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VA Health Care: Collections Fall Short of Expectations

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Report Type Reports and Testimonies
Report Date Sept. 23, 1999
Report No. T-HEHS-99-196
Subject
Summary:

The Department of Veterans Affairs' (VA) collections from third-party insurers declined three years in a row, from $523 million in fiscal year 1995 to $442 million in fiscal year 1998. Fiscal year 1999 figures may show a further decrease. Three factors limit VA's ability to increase what it collects: rising numbers of veterans whose primary insurance is Medicare, increasing enrollment in health maintenance organizations, and VA's emphasis on increasing outpatient care. VA's chances of increasing its collections depend on implementing throughout the agency management improvements being implemented at some facilities. These include medical facilities' improved (1) use of good business management practices, (2) collection of insurance information, (3) documentation of the appropriateness and medical necessity of care being billed, and (4) pursuit of unpaid bills. appropriateness and medical necessity of care being billed, and (4) pursuit of unpaid bills.

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