If another major health crisis occurs, such as the COVID-19 pandemic, the Department of Veterans Affairs may not be able to calculate the additional costs needed to address it, a Government Accountability Office report said Thursday.
The report examines how the Department of Veterans Affairs has allocated $36.7 billion in supplemental funding it received during the pandemic, finding that the department has strengthened numerous health care delivery functions and expanded information technology capabilities for telehealth services during the health crisis and will continue to do so. The cost of providing these services is included in the FY2024 budget.
However, the GAO said that because COVID-19 funds expire in September 2023, the VA lacks the ability to model future disasters and how much funding will be needed to respond to them.
“Other federal agencies have used this model to prepare for catastrophic events,” the report states. “For example, the Federal Emergency Management Agency uses advanced analytical models to inform its flood insurance program and statistical models to determine future Baseline workforce allocation for emergencies.”
When the coronavirus pandemic emerged in 2020, the Veterans Administration was not prepared to provide estimates of supplemental funding needed to respond to the crisis because it lacked historical knowledge and analytical modeling capabilities, GAO officials said.
Instead, it will provide information “such as reported COVID-19 cases” to its funding requests
“China and the Cruise Industry’s Early COVID-19 Response Experience,” along with the Department’s own response data and COVID-19 transmission levels, to fund the CARES Act, the Families First Coronavirus Response Act, and the American Rescue Plan Act Wait for the bill.
According to the report, VHA officials lacked the analytical model needed to predict disaster costs because it did not fall within the scope of the actuarial model used to make the estimates (called the “Enrollee Health Care Forecasting Model”) or the actuarial consultant contract used Help inform it.
“In part because it did not have the modeling capacity to prepare estimates of catastrophic events, VHA was required to make multiple transfers of CARES Act funds to adapt to changing pandemic needs and, at the time it requested ARPA funds, its needs,” the report states. The identification is more general,” said.
GAO also said that while VHA officials also adjusted the EHCPM to account for the impact of the pandemic when developing the department’s fiscal 2024 budget request, they did not detail the key decisions VHA and its actuarial consultants made in developing this year’s model.
EHCPM accounts for 84 percent of VHA’s health care budget estimates, including outpatient and inpatient health care services provided by VA facilities and community providers over two fiscal years, with some budget projections three to four years out.
But VHA has not shared key decision-making details for EHCPM with the VHA Office of Enrollment and Prospecting or VHA Finance, the report said.
“VHA does not document or share all critical EHCPM decisions because there is no requirement to do so,” the report states, noting that the September 2023 standard operating procedures provide “a description of processes and deliverables” but do not require the recording of critical EHCPM decisions. Provide decision-making on EHCPM scenarios to other stakeholders.
GAO made two recommendations, including establishing requirements to document and share the rationale for key EHCPM decisions with VHA internal stakeholders and enhancing VA’s analytical modeling capabilities to explain catastrophic events.
VA officials agree with the recommendations and plan to form a working group to evaluate appropriate models. However, GAO officials said it was “unclear from VA’s response how the task force will enhance VA’s modeling capabilities,” adding that they will continue to monitor the department’s work on the issue.