Conclusions

The implementation of the Lovell FHCC provides a road map to issues that will be encountered in any future attempts to establish FHCCs and offers many examples of ways to overcome or bypass those impediments. It would be extremely beneficial for planners of future FHCCs, and in many cases for existing and future joint ventures, to adopt solutions developed and already approved by the VA and the DoD without having to undertake the long negotiation process that the FHCC had to go through. An important, groundbreaking contribution would be made by the FHCC staff if they developed joint DoD/VA guidance materials, including a best-practices document or guidebook to disseminate local solutions or “fixes” arrived at to solve problems that arose in the implementation of the merger.

RECOMMENDATION 4. The Department of Veterans Affairs and the Department of Defense should systematically compile and analyze the lessons learned from the Captain James A. Lovell Federal Health Care Center merger experience, including both what and what not to do, and disseminate them through onsite consultation, webinars, technical assistance, and other means to other federal health care center sites considering joint ventures and related collaborative arrangements.

Conduct a Comprehensive Evaluation of the Lovell Federal Health Care Center Demonstration

Findings

The Lovell FHCC has been in operation for less than 2 years and is still implementing parts of the integration plan. It is too early to tell how successful the overall integration effort has been or will be when the demonstration period ends in 2015. That there have been substantial one-time 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.



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