Data and information requirements for the Department of Veterans Affairs resource allocation systems

The department of Veterans Affairs (VA) uses a global budgeting process to allocate congressionally appropriated resources to provide medical care to veterans. The Department of Veterans Affairs has developed this process to accommodate the effects of changes in pure inflation, workload, and cost per unit of work in forecasting operating dollars required for facility global budgets. In 1990, VA began shifting to a new method of allocating its global budget called Resource Planning and Management (RPM), based on a capitated system. Facilities receive resources according to their unit costs and the number and type of patients they are expected to serve. A key characteristic of any global budgeting information system is flexibility. The VA information system accesses the portion of each patients's care that is provided at every facility and aggregates this information across all facilities to create a single prorated patient record; the system reconstructs prior years of data into the new patient-centered format to forecast workload. No other health care system in the United States pays for and directly provides such a diverse set of services for such a large population as does VA. Nevertheless, many of the problems VA faces are similar to those of other providers and insurers.