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As operators of two of this nation's largest healthcare systems, DOD and VA are attempting—through collaborative initiatives—to improve access, quality, and cost-effectiveness of care, while also reducing duplication between programs. However, a number of barriers hinder the departments' collaborative efforts. GAO has reported that:

• VA and DOD face barriers that hinder progress at collaboration sites—locations where the two departments share health care resources—including the lack of performance information that could help decision makers assess overall progress to achieve goals relating to health care access, quality, and cost effectiveness.
• VA's and DOD's most fully integrated collaboration project—the joint Federal Health Care Center (FHCC) in Chicago—faces notable problems , including costly delays in IT implementation, and the lack of a comprehensive evaluation plan for assessing if the FHCC produces sufficient benefits in relation to its costs, a finding that may determine whether the FHCC should serve as a model for future collaboration efforts.
• To address fragmentation and duplication in its efforts to provide health care case management and care coordination services for recovering servicemembers and veterans, VA and DOD are developing policies and procedures through a collaborative, interagency strategy. For additional information, see the discussion of the VA/DOD Joint Executive Council role on this issue, as found in the key issue page Continuity of Health Care from DOD to VA.

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