Summary

In response to a congressional request, GAO reviewed the implementation of legislation to promote greater sharing of health care resources between the Veterans Administration (VA) and the Department of Defense (DOD), specifically between the U.S. Air Force Regional Hospital at Elmendorf Air Force Base and the VA outpatient clinic, both in Anchorage, Alaska.

GAO found that: (1) VA use of the DOD aeromedical evacuation system to transport VA beneficiaries in Alaska to both military and VA hospitals in the continental United States could reduce costs; (2) DOD regulations limit VA use of the system and require reimbursement at a rate equal to first-class commercial air fare plus taxes and in-flight medical charges; and (3) because of the DOD charges, VA uses scheduled commercial airline flights to transport its patients and pay federal government contract air fares, which are significantly less than DOD rates. GAO also found that: (1) VA believes that most Alaskan VA patients would not impose a burden on the system, since they are generally ambulatory, occupy only one seat, and require no special in-flight assistance; (2) in January 1987, the Air Force Surgeon General proposed that DOD waive the restriction to permit VA use of the system on a nonreimbursable or marginal-cost basis; (3) the cost to DOD of accepting VA patients when space was available would be minimal; and (4) there is no statutory requirement to restrict VA use of the system or legislation to conflict with the development of a sharing agreement between VA and DOD.