Introduction: Rehabilitation programs for homeless veterans must include mental health, job-retraining, and standard medical services. The costs of effective treatment for homeless veterans are likely to exceed the basic care, capitated amount that is currently provided under the Veterans Equitable Resources Allocation (VERA) model ($271 per veteran per month). Thus, VAMCs that provide care for a high proportion of homeless veterans may be financially disadvantaged.
Methods: We analyzed the cost of outpatient services consumed by 360 veterans who participated in the Compensated Work Therapy (CWT) rehabilitation program for the homeless between 1998 and 2000. Using Decision Support System (DSS) software, outpatient costs were determined during participation in the CWT program and calculated separately for those who successfully completed the program compared to those who did not.
Findings: The average outpatient services cost for veterans who successfully completed the CWT program was $8780 consumed over a mean enrollment period of 9 months ($983 per month), whereas the average costs for unsuccessfuls was $4000 consumed over 3 months of enrollment ($1167 per month). Both groups exceeded the VA's budgetary allowance for the basic care of patients.
Conclusion: The costs of rehabilitating homeless veterans exceed the basic care amount provided under current VA reimbursement policy. Adjustments to the VA reimbursement model may be necessary to avoid financially penalizing the VAMCs that treat homeless veterans. Future studies will focus on understanding the longer-term financial implications of treating homeless veterans and on identifying what factors promote success in the CWT program.
Learning Objectives: 1) to acquaint participants with the Veteran's Administration (VA) system for reimbursing VA medical centers 2) to inform participants about the VA's rehabilitation program for homeless veterans 3) to describe the cost implications of providing rehabilitation and health care services to homeless veterans
Keywords: Cost Issues, Homeless Health Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.