military personnel who depend on local Veteran Affairs
hospitals for care may face a very different health-care
system when a new study is completed.
June, the VA entered Phase 2 of a national initiative
designed to make the $20.3 billion health system more
efficient and less costly to the taxpayer. The effort
was spurred by a General Accounting Office report
that found the system spending more than $1 million
a day to maintain outdated facilities in aging buildings.
response, the VA created the CARES (Capital Assets
Realignment for Enhanced Services) program to determine
how many veterans are served in each of 1,300 hospitals
and clinics in 22 geographic districts.
on facility use and patient distribution produced
by the 18-month effort will be turned over to an independent
commission selected by the Secretary of Veterans Affairs
for evaluation. The study may lead to the consolidation
or closing of some outmoded facilities and more outpatient
The initiative is part of an effort to modernize the
VA's aging health-care system. Built just after World
War II, the system's network was geared to inpatient
care requiring long hospital stays.
had a major effort and been very successful at moving
the VA from this hospital-based system to a primary
care, outpatient mode of medical care," said
Al Sones, public affairs director for Veterans Integrated
Service Network Region 7, which includes hospitals,
outpatient clinics and nursing homes in Georgia, Alabama
and South Carolina. "This gets the veteran in
and out of the medical [center] much faster. It focuses
much more on preventive medicine. We have a lot of
new high-tech equipment and a lot of new procedures
that just don't require hospitalizing veterans like
we did in the past."
number of veterans seeking care — particularly the
aging World War II generation — has put increasing
strain on local resources. In addition, a migration
of retired veterans from the Northeast and Midwest
to the sunny South has shifted the service population.
of the region's 1.5 million veterans, 362,741 are
enrolled in this system, and that number is expected
to soon top 400,000 — triple the number six years
ago. The system includes eight medical centers and
23 outpatient clinics in the three-state area.
of those vets received care at the sprawling 12-story
Atlanta VA Medical Center on Clairmont Road in Decatur.
Built in 1967 as a 400-bed inpatient facility, the
center now has just 173 beds for overnight stays following
a two-year, $5.7 million renovation effort. So far
this year, 46,106 patients have been treated and released
the same day, compared with just 5,217 inpatients.
those numbers, the Atlanta Network is providing services
to about 10 percent of its potential market, said
Molly Reynolds, public affairs officer at the Atlanta
VA Medical Center.
Atlanta — just this year — we exceeded the number
of outpatient visits from last year," she said.
of program's effects
Atlanta officials don't know yet what CARES
will mean for local health care, but they don't believe
it will result in any facilities being shut down.
is not going to reduce health-care services at all,"
Sones said. "It's basically going to focus on
the care that is being delivered."
it is likely to be a year before any decisions are
made about reforms, officials already have a preview
of what CARES will look like. The first pilot effort
was recently completed in Region 12, which includes
Chicago, upper Illinois, Wisconsin and upper Michigan.
three areas were considered individual markets because
of the particular way veterans were concentrated.
the pilot program, what they found was that up in
Wisconsin and upper Michigan areas, there was a need
for more outpatient clinics," said Kerri Childers,
spokeswoman for the VA's CARES program.
Chicago, Lakeside, one of the city's three hospitals,
was converted to an outpatient facility.
the money saved from closing the inpatient beds at
Lakeside, we were able to expand and improve the other
two major hospitals in the area," she said.
than 80 percent of the care provided to the 4.5 million
veterans who use the system is on an outpatient basis,
officials contend that, ultimately, the system will
be more responsive to the needs of veterans. Clinics
will be closer to where patients live and, through
an upcoming educational program, they will have a
better idea of what kind of care is available to them.
2002 American City Business Journals Inc.