Fairfield Veterans Affairs Outpatient Clinic at Travis AFB (Photo: Kristina P. Cilia)
Veterans receiving medical care at military bases continue to face obstacles despite agreements meant to improve access and reduce costs, according to a new Government Accountability Office, GAO, report. The VA and DOD have established 185 sharing agreements that allow Veterans and Service Members to receive care at each other’s facilities. However, the GAO found ongoing issues that undermine the benefits of these partnerships.
Among the most common problems are delays at base entry gates, incompatible electronic medical records systems, and slow reimbursement processes. Veterans often face long waits to get through military security, even when they have scheduled medical appointments. While security checks are standard for base access, the report noted that these delays interfere with timely care.
The report also highlighted that VA and DOD medical staff must frequently enter patient information into two separate digital health systems, increasing administrative workload and the risk of errors. Differences in billing practices further complicate coordination, sometimes causing long delays in payments between departments. At one location, officials said the DOD limited VA patient referrals due to reimbursement backlogs. Between fiscal years 2018 and 2022, the VA owed over $87 million for services provided by the DOD, eventually paying $76 million more in 2024 to settle those claims.
The sharing agreements between DOD and VA are intended to expand access to specialized care, such as surgery, mental health services, and orthopedics, particularly when services are unavailable at a Veteran’s local VA facility or cannot be provided quickly. In some cases, military doctors use VA hospital operating rooms, and VA staff treat patients in military dental clinics. According to the report, these arrangements typically cost about 20% less than care from civilian providers.
Despite the potential benefits, the GAO found that the VA and DOD do not systematically evaluate whether the agreements are achieving their goals. The report recommends that both departments create a performance management process, including goals, metrics, and regular reviews.
Additionally, the report stated that most new sharing opportunities are identified by local facility staff. The lack of a centralized, department-level strategy means many potential agreements may go unexplored. GAO recommended developing a nationwide system to identify and implement additional sharing arrangements.
The VA operates 170 medical centers and 1,200 clinics, while the DOD runs nine medical centers, 36 hospitals, and more than 500 clinics worldwide. Together, they serve over 18 million Veterans and Service Members. GAO concluded that improved collaboration will lower costs and expand timely care for both populations.
Author: Rikki Almanza
Rikki is a Web Content Coordinator for the American Legion, Department of California. With a deep-rooted family connection to the military, Rikki is committed to using her skills and knowledge to provide valuable assistance and resources to servicemembers and veterans.