Government (Veterans Administration, Active Duty Military)
Select:
The Federal government funds two independent health care systems; one for active duty military
personnel (and their dependents) and one for veterans. Eligible patients may receive
hospitalization in the hospitals of the system. The system also provides for insurance
benefits if care is needed that cannot be provided by the military or veterans hospital system.
Financing Community Hospitals
These government hospitals are funded under global budgets. Hospitals do not receive per
patient payments. However, their overall budgets are determined by overall volume of patients
and overall costs.
Financing Academic Hospitals
Active Duty and Department of Veterans Affairs hospitals are frequently academic facilities.
The active duty military has their own medical school and postgraduate training programs.
These are funded under global budgets. Similarly, the education programs of the veterans
affairs hospitals are also funded under global budgets.
Financing Subacute and Skilled Care
The VA funds an extensive system of subacute and skilled care facilities, both within its system and on a contract basis with other facilities. The active duty military system is similar.
Financing Custodial Care
The active duty military personnel who need custodial care are discharged from active duty. Custodial care is provided by the Department of Veterans affairs for eligible veterans. Service-connected disability is always covered. Otherwise, eligible veterans are means-tested before eligibility is determined. The VA has its own nursing homes. In addition, some veterans have their custodial care paid for under contracts.
Financing Ambulatory Outpatient Care
The government health care systems for active duty and veterans is governed within global budgets. Active duty personnel are covered by a health plan called CHAMPUS which does pay for some services outside of the military system.
Financing Home Care
Home care has not been a focus for the government run programs. Some Veterans Administration hospitals do have a Home-Based Health Care (HBHC) program. However, the services provided are limited to assessment and monitoring services usually. They do not provide the range of services, or expertise of the usual home health care agencies.
Financing Hospice Care
The CHAMPUS insurance coverage for active duty military covers hospice care.
The Department of Veterans Affairs covers hospice and palliative care by statute. Services can be provided directly and through contracts with medicare-certified hospice programs in their communities. However, implementation is variable thorught the system.
Next, consider the financing of physicians.
 |
Home •
Development •
Rationale •
Elements •
Lexicon •
Resources •
FAQ
Summary •
Overview •
Contributors •
Help •
Get Acrobat •
Contact Us
|
|
CAPCManual Attribution:
von Gunten CF,
Ferris FD,
Portenoy RK,
Glajchen M, eds.
CAPCManual: How to Establish A Palliative Care Program.
New York, NY: Center to Advance Palliative Care, 2001.
©
Center for Palliative Studies, San Diego Hospice & Palliative Care, San Diego, CA
and
The Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, NY, 2001
Permission to reproduce for non-commercial educational purposes with display of
attribution and
copyright is granted.
Last updated: February 20, 2002
|
|
