{
  "schemaVersion": 1,
  "deskKey": "GAO-25-107497:recommendation-2",
  "title": "VA–DOD health care sharing",
  "page": "https://america.co/oversight/va-dod-health-care-sharing",
  "selectedAction": "Recommendation 2",
  "actorType": "agency",
  "owner": "VA Under Secretary for Health, working with DOD",
  "source": {
    "report": "GAO-25-107497",
    "url": "https://www.gao.gov/products/GAO-25-107497",
    "published": "2025-06-30",
    "publiclyReleased": "2025-06-30",
    "consulted": "2026-10-05",
    "statusInConsultedSource": "Open",
    "latestSelectedCommentAsOf": "2026-03"
  },
  "progressSummary": "GAO’s March 2026 comment says the interagency working group produced a utilization assessment tool and resource-sharing playbook, and began collecting data. Its first full performance review is planned for the third quarter of fiscal year 2027. These are reported implementation steps, not a completed effectiveness evaluation.",
  "annualContext": {
    "report": "GAO-26-108505",
    "url": "https://www.gao.gov/products/gao-26-108505",
    "published": "2026-05-12",
    "benefitType": "potential-savings",
    "estimateAsReported": "Tens of millions annually",
    "timeHorizon": "Annual; topic-level potential",
    "estimateAttribution": "GAO 2026 annual report",
    "scope": "Topic-level; not a price tag solely on the selected action",
    "basis": "GAO’s 2026 annual report describes topic-level potential savings in the tens of millions of dollars annually, alongside improved access to care. It does not assign that amount solely to Recommendation 2."
  },
  "boundary": "A tool being issued does not prove it is used consistently or that patients receive better care. The report’s 185 agreements are an April 2025 inventory, not a count verified for October 2026. No actual savings figure is asserted here.",
  "evidenceToCloseSummary": "Evidence that the departments evaluate agreement performance, apply the process, and use the findings to make changes. A new PDF alone is not the end of the evidence chain.",
  "proposedEvaluation": {
    "notOfficialProcedure": true,
    "test": "Compare comparable services before and after a sharing change. Include wait times, travel burden, access, total delivery cost, and the cost of administering the agreement. Keep patient-level information private.",
    "questions": [
      "Which agreements have complete baseline and follow-up measures?",
      "What decisions changed because of the assessment?",
      "Did access improve without shifting cost or travel burden onto patients?"
    ]
  },
  "cashAvailable": false,
  "actualSavingsAsserted": false,
  "coverage": "One selected action; not every recommendation in the report",
  "compiler": "America.co public-resource desk; AI-assisted; no expert review claimed"
}