Expansion of joint healthcare initiatives between VA and DoD, yet challenges emerge in evaluating the ensuing effects
The Department of Veterans Affairs (VA) and the Department of Defense (DoD) have been collaborating through health care sharing agreements, with the potential for cost avoidance and expanded service opportunities. However, the effectiveness of these agreements is challenging to assess due to various obstacles.
One of the most promising avenues for expanding care access and efficiency is the shared use of virtual health and telehealth services. By coordinating these resources, the VA and DoD aim to reduce redundancies and jointly utilise resources, potentially avoiding costs. Both agencies are also migrating to the same Electronic Health Record (EHR) platform, Oracle Cerner's MHS GENESIS, to facilitate data sharing and improve cost efficiency and care continuity.
However, complete interoperability between VA and DoD health records remains unresolved, with systems not yet fully exchanging or integrating health data seamlessly. This lack of integration limits real-time coordination and reduces potential cost savings from avoiding duplicate services or facilitating timely care transitions.
Moreover, both agencies operate largely independent clinical and administrative processes, hampering collaborative efficiencies. Lack of agreement on telehealth integration and variable leadership coordination contribute to ongoing gaps in sharing resources effectively.
Evaluations of cost avoidance and expanded sharing are also difficult without comprehensive, integrated data. Cost impacts may be obscured by dual system usage of veterans and private sector providers, and inconsistent tracking of services across systems. Technological and infrastructure limitations, such as the DoD's ongoing transition to a cloud-based health data system, further restrain full deployment of effective sharing capabilities.
Despite these challenges, Alyssa Hundrup, the health care director at the Government Accountability Office (GAO), emphasised the importance of these agreements for sharing health care resources efficiently. As of April 2025, there are 185 active health care sharing agreements between the VA and DoD, a 14% increase from 162 agreements in 2022.
Continued efforts to integrate technology, standardise data sharing, and coordinate leadership priorities are critical for improving effectiveness and realising potential savings. The GAO has highlighted the importance of tracking cost-avoidance measures to understand the types of cost savings and apply them in other agreements. The DoD has agreed to finalise guidance on when and how to pursue non-reimbursable agreements, but a timeline for issuing new procedures has not yet been provided.
In conclusion, VA-DoD health care sharing agreements hold substantial promise for cost avoidance and expanded health care services. However, the assessment of their effectiveness is hindered by incomplete interoperability, fragmented coordination, and technological limitations, making it difficult to comprehensively quantify cost avoidance or sharing benefits at present.
- The workforce of both the VA and DoD could be reimagined to focus on improving the integration of health records and telehealth services, which are crucial for realizing potential savings through health care sharing agreements.
- As the federal workforce adopts a health-and-wellness approach, it's essential to address medical-conditions related challenges in the VA-DoD health care sharing agreements, such as the lack of seamless health data exchange and standardized data sharing protocols, to enhance the effectiveness of these agreements.
