B. Overview of VA Cost Methods

2. What data are available on VA costs?

Cost Distribution Report (CDR)

The Cost Distribution Report (CDR) is a historical cost dataset, that was replaced by DSS. It allocated cost reported in the general ledger (FMS) to estimate the cost of VA departments, including patient care departments and other units. These allocations are based on service chief estimates of staff activities.While there is concern about the accuracy of CDR cost estimates, they are the only data relating VA expenditures to types of patient care before the advent of DSS in 1998.
View an overview of the Cost Distribution Report (CDR)

Decision Support System (DSS)

The Decision Support System includes economic and clinical data on all VA facilities. Although detailed production data reside at Austin, access to these data requires permission from each individual facility. A national extract has been created with encounter level summary cost data from all VA facilities.
View an overview of the Decision Support System (DSS)

Fee Basis Files

The fee basis files report the cost of care provided under contract to VA. There are separate files for inpatient stays, inpatient ancillary services, outpatient care, pharmacy, and travel. While there is some information characterizing hospital stays (in the Non-VA PTF file) little information is available on other types of healthcare reported in these files. Care provided in state veterans' homes and under VA sharing agreements are not reported in these data.
View an overview of the fee basis files

Financial Management System (FMS)

This is the summary of the VA general ledger. FMS is a source of VA nationwide data that can be used for cost analysis. For example, the analyst can find the national average annual cost of different types of staff, or the average cost of staff at a particular local VA medical center.
View an overview of the Financial Management System (FMS)

Fixed Asset Package

The Fixed Asset Package tells the acquisition cost, useful life, depreciation, and undepreciated balance of all VA capital assets.

PAID system

The PAID system contains information on VA payroll, with data on the salaries and benefits of individual employees. The information is highly confidential, and it is extremely difficult to gain access to these data.

VA Utilization files

Economics researchers need utilization data to estimate healthcare costs. Key files include data on hospital stays found in the Patient Treatment File, data on outpatient visits in the Outpatient Care Files, and information on the acuity of long-term care patients found in the Patient Assessment File.
View an overview of the VA Utilization files