The reorganization of the Veterans Health Administration away from a centralized system to a set of regional networks funded according to the number and type of patients each network serves helped the agency successfully carry out a large-scale quality improvement effort in the 1990s, according to Harvard Professor Ashish Jha, who has studied VHA extensively.
Jha’s conclusions are part of a Congressional Budget Office assessment of the VHA’s quality initiatives requested by the House Veterans’ Affairs and Appropriations Committees.
The agency provides medical services through about 150 medical centers, and over 900 outpatient clinics and other facilities to more than 5 million veterans a year at a cost of over $40 billion.
According to the report, beginning in the mid 1990s VHA eliminated underutilized inpatient beds and facilities, expanded outpatient clinics, and restructured eligibility rules.
VHA has achieved improvements in the quality indicators it measures and for which it holds its staff accountable, CBO concluded.