NEWS FROM….

CONGRESSMAN LANE EVANS

RANKING DEMOCRATIC MEMBER

COMMITTEE ON VETERANS AFFAIRS

    U.S. HOUSE OF REPRESENTATIVES

FOR RELEASE: July 6, 2000

Washington, DC – "Despite increases in appropriations, rural health care for veterans remains seriously under-funded," said Congressman Lane Evans of Illinois, Ranking Democratic Member of the House Veterans' Affairs Committee. "I want to know why, and I think I do. I suspect problems with VERA." Evans announced today he and several House colleagues are requesting that the General Accounting Office (GAO) examine the effectiveness of the Department of Veterans Affairs (VA) system for allocating health care resources.

The VA implemented its Veterans Equitable Resource Allocation (VERA) system in 1997 to comply with legislation requiring VA to shift funding to the South and the West, reflecting demographic change as veterans grow older, and provide them equitable access to care. VERA is about to begin its fifth year, in a fiscally strapped veterans health care system thousands of veterans rely on. "There is not enough VA funding – especially in rural America -- for wild guesses," Evans said. "I've got to be certain the figures are done with a sharp pencil."

Evans announced today he and colleagues from the Midwest have written to Comptroller General David Walker, requesting a study by the GAO to determine whether the VA's VERA formulas adequately address the difficulty and the high cost of providing health care services in rural areas. "Simplistic ratios won't make allowances for problems of scale in operating facilities in rural and small town areas," said Evans.

"The VA has recently concluded that the cost of caring for rural veterans is less expensive than urban veterans," the letter from the Midwestern Congressman said. "However, this finding was based on the services rural VISNs [Veterans Integrated Services Networks] currently provide, which are limited because of budget restrictions. The VA may have failed to consider that veterans in urban areas have access to more services and that rural areas have low utilization of health care services because people will often forego care rather than travel long distances. VA may actually be penalizing rural veterans for having fewer services available to them."

Members felt a GAO review also would help identify additional improvements needed to more fairly allocate future resources. Although they agree some reallocation of resources was necessary, Evans and others believe it is possible that VERA does not properly consider the basic overhead expenses of operating medical care facilities or the cost of serving all veterans. "The result," Evans said, "is that although Congress has increased VA health care funding by 23.5 percent since FY1996, the VA nonetheless projects the four VISNs in the Midwest and the Northeast will need supplemental appropriations this year." Evans says he believes the GAO should evaluate the circumstances of these VISNs and determine whether VERA responded adequately.

"In particular," the Midwestern members wrote, "we are interested in better understanding VERA's effect on health care for rural veterans, the relationship of enrollment to resource allocation, and the circumstances in the [VISNs] that have requested supplements to their VERA allocations." This suggested analysis would build on GAO's earlier work assessing VERA's early implementation in 1997 and 1998.

"VERA's aim," said Evans, "was to provide comparable funding for comparable workloads, so all veterans receive the same quality of care no matter where they live. It was expected that under the VERA model, VISNs in the Midwest and Northeast would lose resources while those in the Southeast and Southwest would gain. However, the effects in the rural areas in particular have been worse than Congress expected."