Integrating federal health care resources at the local level

Hospitals throughout the country are increasingly sharing health services, jointly purchasing supplies, and merging. The Veterans Administration (VA)-Department of Defense (DoD) Health Resources Sharing Law of 1982 (PL 97-174) has encouraged much closer relationships between hospitals of these agencies than had existed previously. All VA hospitals within 50 miles of a military treatment facility now have multiservice agreements. Before passage of the law, only a handful of facilities were involved in limited sharing. Closer relationships have led to expanded care for federal beneficiaries at considerable cost savings. In Albuquerque, New Mexico, for example, the VA Medical Center houses the VA and Air Force hospital operations, obviating the need for a separate freestanding hospital. The lack of VA authority to receive reimbursement from the Civilian Health and Medical Program for the Uniformed Services and a lack of a reimbursement incentive for military hospitals to share are identified as factors preventing greater coordination. Even greater local integration of services is likely to occur in the future.