§ 201. INDEPENDENT ASSESSMENT OF THE HEALTH CARE DELIVERY SYSTEMS AND MANAGEMENT PROCESSES OF THE DEPARTMENT OF VETERANS AFFAIRS.

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Independent Assessment.— Assessment .— Not later than 90 days after the date of the enactment of this Act [ Aug. 7, 2014 ], the Secretary of Veterans Affairs shall enter into one or more contracts with a private sector entity or entities described in subsection

(b)to conduct an independent assessment of the hospital care, medical services, and other health care furnished in medical facilities of the Department. Such assessment shall address each of the following: Current and projected demographics and unique health care needs of the patient population served by the Department. Current and projected health care capabilities and resources of the Department, including hospital care, medical services, and other health care furnished by non-Department facilities under contract with the Department, to provide timely and accessible care to veterans. The authorities and mechanisms under which the Secretary may furnish hospital care, medical services, and other health care at non-Department facilities, including whether the Secretary should have the authority to furnish such care and services at such facilities through the completion of episodes of care. The appropriate system-wide access standard applicable to hospital care, medical services, and other health care furnished by and through the Department, including an identification of appropriate access standards for each individual specialty and post-care rehabilitation. The workflow process at each medical facility of the Department for scheduling appointments for veterans to receive hospital care, medical services, or other health care from the Department. The organization, workflow processes, and tools used by the Department to support clinical staffing, access to care, effective length-of-stay management and care transitions, positive patient experience, accurate documentation, and subsequent coding of inpatient services. The staffing level at each medical facility of the Department and the productivity of each health care provider at such medical facility, compared with health care industry performance metrics, which may include an assessment of any of the following: The case load of, and number of patients treated by, each health care provider at such medical facility during an average week. The time spent by such health care provider on matters other than the case load of such health care provider, including time spent by such health care provider as follows: At a medical facility that is affiliated with the Department. Conducting research. Training or supervising other health care professionals of the Department. The information technology strategies of the Department with respect to furnishing and managing health care, including an identification of any weaknesses and opportunities with respect to the technology used by the Department, especially those strategies with respect to clinical documentation of episodes of hospital care, medical services, and other health care, including any clinical images and associated textual reports, furnished by the Department in Department or non-Department facilities. Business processes of the Veterans Health Administration, including processes relating to furnishing non-Department health care, insurance identification, third-party revenue collection, and vendor reimbursement, including an identification of mechanisms as follows: To avoid the payment of penalties to vendors. To increase the collection of amounts owed to the Department for hospital care, medical services, or other health care provided by the Department for which reimbursement from a third party is authorized and to ensure that such amounts collected are accurate. To increase the collection of any other amounts owed to the Department with respect to hospital care, medical services, and other health care and to ensure that such amounts collected are accurate. To increase the accuracy and timeliness of Department payments to vendors and providers. The purchasing, distribution, and use of pharmaceuticals, medical and surgical supplies, medical devices, and health care related services by the Department, including the following: The prices paid for, standardization of, and use by the Department of the following: Pharmaceuticals. Medical and surgical supplies. Medical devices. The use by the Department of group purchasing arrangements to purchase pharmaceuticals, medical and surgical supplies, medical devices, and health care related services. The strategy and systems used by the Department to distribute pharmaceuticals, medical and surgical supplies, medical devices, and health care related services to Veterans Integrated Service Networks and medical facilities of the Department. The process of the Department for carrying out construction and maintenance projects at medical facilities of the Department and the medical facility leasing program of the Department. The competency of leadership with respect to culture, accountability, reform readiness, leadership development, physician alignment, employee engagement, succession planning, and performance management. Particular elements of certain assessments.— Scheduling assessment .— In carrying out the assessment required by paragraph (1)(E), the private sector entity or entities shall do the following: Review all training materials pertaining to scheduling of appointments at each medical facility of the Department. Assess whether all employees of the Department conducting tasks related to scheduling are properly trained for conducting such tasks. Assess whether changes in the technology or system used in scheduling appointments are necessary to limit access to the system to only those employees that have been properly trained in conducting such tasks. Assess whether health care providers of the Department are making changes to their schedules that hinder the ability of employees conducting such tasks to perform such tasks. Assess whether the establishment of a centralized call center throughout the Department for scheduling appointments at medical facilities of the Department would improve the process of scheduling such appointments. Assess whether booking templates for each medical facility or clinic of the Department would improve the process of scheduling such appointments. Assess any interim technology changes or attempts by Department to internally develop a long-term scheduling solutions with respect to the feasibility and cost effectiveness of such internally developed solutions compared to commercially available solutions. Recommend actions, if any, to be taken by the Department to improve the process for scheduling such appointments, including the following: Changes in training materials provided to employees of the Department with respect to conducting tasks related to scheduling such appointments. Changes in monitoring and assessment conducted by the Department of wait times of veterans for such appointments. Changes in the system used to schedule such appointments, including changes to improve how the Department— measures wait times of veterans for such appointments; monitors the availability of health care providers of the Department; and provides veterans the ability to schedule such appointments. Such other actions as the private sector entity or entities considers appropriate. Medical construction and maintenance project and leasing program assessment .— In carrying out the assessment required by paragraph (1)(K), the private sector entity or entities shall do the following: Review the process of the Department for identifying and designing proposals for construction and maintenance projects at medical facilities of the Department and leases for medical facilities of the Department. Assess the process through which the Department determines the following: That a construction or maintenance project or lease is necessary with respect to a medical facility or proposed medical facility of the Department. The proper size of such medical facility or proposed medical facility with respect to treating veterans in the catchment area of such medical facility or proposed medical facility. Assess the management processes of the Department with respect to the capital management programs of the Department, including processes relating to the methodology for construction and design of medical facilities of the Department, the management of projects relating to the construction and design of such facilities, and the activation of such facilities. Assess the medical facility leasing program of the Department. Timing .— The private sector entity or entities carrying out the assessment required by paragraph

(1)shall complete such assessment not later than 240 days after entering into the contract described in such paragraph. Private Sector Entities Described .— A private entity described in this subsection is a private entity that— has experience and proven outcomes in optimizing the performance of the health care delivery systems of the Veterans Health Administration and the private sector and in health care management; and specializes in implementing large-scale organizational and cultural transformations, especially with respect to health care delivery systems. Program Integrator.— In general .— If the Secretary enters into contracts with more than one private sector entity under subsection (a), the Secretary shall designate one such entity that is predominately a health care organization as the program integrator. Responsibilities .— The program integrator designated pursuant to paragraph

(1)shall be responsible for coordinating the outcomes of the assessments conducted by the private entities pursuant to such contracts. Report on Assessment.— In general .— Not later than 60 days after completing the assessment required by subsection (a), the private sector entity or entities carrying out such assessment shall submit to the Secretary of Veterans Affairs, the Committee on Veterans’ Affairs of the Senate, the Committee on Veterans’ Affairs of the House of Representatives, and the Commission on Care established under section 202 a report on the findings and recommendations of the private sector entity or entities with respect to such assessment. Publication .— Not later than 30 days after receiving the report under paragraph (1), the Secretary shall publish such report in the Federal Register and on an Internet website of the Department of Veterans Affairs that is accessible to the public. Non-Department Facilities Defined .— In this section, the term ‘non-Department facilities’ has the meaning given that term in section 1701 of title 38 , United States Code.

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§ 201

INDEPENDENT ASSESSMENT OF THE HEALTH CARE DELIVERY SYSTEMS AND MANAGEMENT PROCESSES OF THE DEPARTMENT OF VETERANS AFFAIRS.

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