Department of Veterans Affairs May Close Some ‘Unnecessary’ Hospitals

In an "ambitious effort" to reform the veterans' health care system, the Department of Veteran Affairs hopes to close some "outdated or unnecessary" VA hospitals, the Washington Post reports. Government studies have "regularly" found that "it is no longer cost efficient to maintain so many" full service hospitals, and through the Capital Asset Realignment for Enhanced Services program, the VA hopes to close some hospitals in favor of "smaller clinics and outpatient care." However, VA efforts to close facilities in the past have "run into a wall of opposition" from veterans groups and area politicians. For example, in Chicago, demonstrations "quickly turned ugly," with veterans denouncing a proposal to eliminate inpatient care at Lakeside veterans hospital and renovate two other hospitals. In Wisconsin, the VA has received "mainly negative" comments about a plan to build three outpatient facilities and shift 75 nursing home beds to a different facility in the state. According to the VA, based on a study conducted by the consulting firm Booz Allen & Hamilton, the department's recommendations for Chicago and the surrounding region would save an estimated $720 million over 20 years. The VA plans to conduct similar studies in other regions, including the Boston area, New York City and the Pacific Northwest. The Post reports the VA has opened proposals to close or rehabilitate hospitals to public comment through Sept. 14. After the comment period, VA Secretary Anthony Pricipi will likely decide which facilities to close. However, decisions that include construction "ultimately" will require congressional action to appropriate funding, which may not occur until 2004, the Post reports. Still, the House may pass legislation that would allow Pricipi "wide discretion" to select which renovation projects to pursue and provide funding for the "most decrepit" VA hospitals. Frances Murphy, deputy undersecretary of health at the VA, said, "We've changed the paradigm for the way we've done our planning in the past. We are now starting with the veteran at the center of our planning process. It's all about deciding what they will need from us. ... We are in the health care business ... not in the hospital business." She added that the VA will likely "overcome many objections" to plans to close facilities in favor of outpatient clinics after the department concludes studies in each region (White, Washington Post, 8/14).