Profile of VA Facility Users

While many veterans received medical care during the early 1990s, relatively few obtained their care from VA facilities. Veterans who used VA facilities generally had lower incomes and were less likely to have private insurance than veterans who used non-VA facilities. VA Facility Users Generally Had Lower Incomes Than Users of Non-VA Facilities

Using VA patient treatment records and Internal Revenue Service information, we examined the incomes of the 2.2 million veterans who used VA medical facilities in 1991 and found that two-thirds had incomes under $20,000, and about one-third of these had incomes under $5,000.However, VA’s survey of veterans in 1992 showed that only about 32 percent of all veterans had gross family incomes below $20,000. Our analysis of 1990 census data showed that about 50 percent of all veterans lived over 25 miles from a VA hospital, including 6 percent who lived over 100 miles away, and 34 percent lived over 25 miles from a VA clinic. For example, about 11 percent of all veterans lived within 5 miles of a VA hospital, and they accounted for 22 percent of the facility users. Comparison of Veterans’ Access to VA and Private Facilities in Selected Markets

Veterans generally have less access to VA medical facilities than to private facilities, as the following market examples show. Private facilities are often more convenient. 3.) 4.) Options VA Might Explore for Improving Accessibility of VA Health Care

In February 1995, VA issued an interim policy that encouraged its field offices to employ all means at their disposal, consistent with funding availability and federal law, to improve veterans’ access to VA health care. VA could improve access for one or more of the high-priority groups. For example, a medical center could target veterans with service-connected disabilities. On the positive side, VA-operated facilities could give VA more control over resources, potentially lessening the risk of fraud, waste, and abuse. We revised the report to show that we focused on veterans’ access to standard health care benefits.
Why GAO Did This Study

Pursuant to a congressional request, GAO provided information on veterans' use of Department of Veterans Affairs' (VA) medical facilities, focusing on: (1) users' characteristics; (2) the geographic accessibility of VA and private medical facilities that provide standard benefits; and (3) options to improve accessibility of VA health care.

What GAO Found

GAO found that: (1) in the early 1990s, over 80 percent of veterans who received health care services obtained them from non-VA sources; (2) veterans who used VA medical facilities generally had lower incomes and were less likely to have private health insurance than veterans who obtained health care from non-VA facilities: (3) veterans with service-connected disabilities utilized VA facilities more often than other veterans; (4) about 50 percent of all veterans lived over 25 miles from a VA facility and 11 percent of veterans lived within 5 miles of a VA hospital; (5) although VA hospitals and outpatient clinics were geographically less accessible to veterans than private medical facilities, veterans had better access to certain specialty services through VA facilities; (6) options to improve veterans' access to VA health care include determining whether to improve access for current users, all veterans, or selected veterans groups, and comparing the costs of VA-provided services and contractor-provided services; and (7) although VA facilities are more costly to operate, they lessen the chances of program abuse by giving VA more control over resources.