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22대 대한민국 국회 국회정보길라잡이 국회의원검색
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Title page 1

Contents 3

Highlights 2

Letter 5

Background 10

Developing VHA's Health Care Budget Projection Using the EHCPM 10

Role of VHA and Its Actuarial Consultant in Developing Health Care Model Estimates 11

VHA's Budget Projection for Inclusion in the President's Budget Request 12

VHA's Process for Updating its Actuarial Model Estimates Includes Gathering Data and Meeting with Program Offices 15

VHA's Processes for Developing its Health Care Cost Model Align with Most but Not All Relevant Standards 19

VHA's Processes Largely Align with Relevant Standards 20

VHA's Processes Do Not Fully Align with Certain Aspects of Relevant Standards 21

VHA Uses Performance Measures to Assess Consultant, but Lacks Specific Oversight Responsibilities in its Standard Operating Procedure 28

Conclusions 31

Recommendations for Executive Action 32

Agency Comments 33

Appendix I. Objective, Scope, and Methodology 35

Appendix II. Actuarial Standards of Practice Relevant to VHA's Actuarial Modeling 40

Appendix III. VHA's Actuarial Consultant's Tasks, Deliverables, and Required Due Dates for the Deliverables 42

Appendix IV. Quality Assurance Surveillance Plan Performance Metrics Used to Assess VHA's Actuarial Consultant 50

Appendix V. GAO Contact and Staff Acknowledgments 51

Tables 3

Table 1. Actuarial Standards of Practice Relevant to Enrollee Health Care Projection Model (EHCPM) Modeling and Examples of How the VHA's... 40

Table 2. Full List of Project Tasks, Deliverables, and Required Delivery Dates for VHA's Actuarial Consultant as Outlined in the Performance... 42

Table 3. Quality Assurance Surveillance Plan Performance Metrics Used to Assess the VHA's Actuarial Consultant, as of April 2025 50

Figures 4

Figure 1. Basic Outputs of VHA's Enrollee Health Care Projection Model (EHCPM) 11

Figure 2. Timeline for Developing the Budget Projection for VA Health Care Services Included in the President's Budget Request 14

Figure 3. VHA Process for Updating the Enrollee Health Care Projection Model (EHCPM) and Model Delivery 16

Figure 4. Sources of Risk Contributing to the Enrollee Health Care Projection Model (EHCPM) Estimate Used to Support the Veterans Health Administration's... 26

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