costs is clear, but whether these have led or will lead to lasting efficiencies or can be adopted by future FHCCs to avoid unnecessary costs is not yet known.

The Lovell FHCC is tracking certain performance indicators designed to inform about the relative degree of success or failure, for example, if the facility is providing poor, less, or more expensive care; hurting operational readiness; reducing patient satisfaction and staff morale; or providing fewer education and research opportunities. However, the VA and the DoD have not adopted a comprehensive evaluation plan to judge objectively the success of the Lovell FHCC at the end of the 5-year demonstration period and to help them to decide whether the Lovell FHCC would be applicable in other locations.

Conclusions

Without a formal evaluation plan, the success of the integration effort will be more difficult to determine after the 5-year demonstration period than it should be because not all the data needed for such an evaluation are being collected prospectively.

RECOMMENDATION 5. In considering the Captain James A. Lovell Federal Health Care Center merger and future collaborative arrangements, the Department of Veterans Affairs and the Department of Defense should develop a comprehensive evaluation framework with defined and measurable criteria for assessing performance that take into account local and national contexts, organizational capabilities and readiness, implementation plans, intermediate outcomes, and likely long-term impact.

The committee offers a comprehensive evaluation framework in Appendix B.

Expand the Knowledge Base on Federal Health Care Collaborations

Findings

The DoD and the VA have not systematically analyzed the experience of the Lovell FHCC and the lessons that may be learned from it in considering if and where to establish additional integrated VA/DoD health care centers modeled after the Lovell FHCC merger.



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