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Blind
Rehabilitation Centers (BRCs) and programs that are admittedly
resource-intensive are costly. Currently these programs are being
viewed as potential moneymakers under the Veterans Equitable Resource
Allocation (VERA) model. As you know, VERA is the allocation model
utilized for distributing funds to the networks. Under VERA, there
are two reimbursement rates. The basic rate provides reimbursement
for the provision of primary or basic care. The high reimbursement
rate is intended to cover the higher costs of the more complex
and specialized programs such as blind rehabilitation. A blinded
veteran must spend at least one day in a BRC bed to qualify for
the high reimbursement rate paid for complex care. Under the current
methodology, the reimbursement rate goes to the veterans host
network on a pro-rated basis. That is, if the BRC providing the
blind rehabilitation is located in another network, the cost of
that care is allocated to that network and the remainder of the
high reimbursement rate remains within the veterans home network.
Network and/or facilities have evidently discovered that if the
length of stay in these programs is short enough, their cost is
substantially reduced, therefore increasing a potential profit
margin. This process then provides either the network or facilities
with funds to operate other programs and services.
Given the current amount for complex care ($42,000),
it appears there are sufficient dollars being allocated for the
specialized services required by blinded veterans. For example,
if the cost of a single episode of blind rehabilitation provided
in a residential BRC is approximately $25,000, that leaves in
excess of $10,000 in the veterans home network. In our view, these
dollars should be utilized either for ongoing care of that blinded
veteran or for providing services to other veterans with the same
disability. We do not believe this is the case, however, and,
in actuality, those dollars are being utilized to fund other medical
or network services.
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