Mind the Double-Dip: RAND Calls for Better Tracking in VA Health Care
84% Have Other Insurance: RAND Says VA Must Curb Duplicate Spending
Veterans aren’t short on coverage — and that’s the problem. A new analysis from the RAND Epstein Family Veterans Policy Research Institute finds that about 84% of the 8.2 million veterans enrolled in VA health care also carry another form of coverage (Medicare, TRICARE, Medicaid, or private insurance). RAND’s researchers say that much overlap “raises questions about whether different programs are making duplicative payments for the same care.”
This lands just as the VA and Centers for Medicare & Medicaid Services (CMS) opened a data-matching partnership that already flagged $106 million in duplicate provider payments over six years — money both agencies say they’re moving to recover. VA News And while that’s a start, outside experts say meaningful fixes require better record-keeping and tighter tracking across all the systems veterans use.
What’s Actually Going Wrong?
- Siloed systems. VA is a care provider and payer; Medicare and TRICARE are insurers. They don’t act as each other’s secondary payer, which means the same veteran can touch multiple systems without a single source of truth on who should pay.
- Overlapping bills. Providers sometimes bill both VA community care and Medicare for the same encounter — hence that $106M figure and the new VA–CMS data match.
- Medicare Advantage incentives. Separate investigations show the government often pays Medicare Advantage plans for veterans who still rely heavily on VA care — another flavor of double-spend risk.
Why This Matters …
- Every duplicate dollar is a dollar not spent on you. Waste drains resources from claims processing, specialty clinics, prosthetics, mental health, and toxic-exposure care — the lifelines our community depends on.
- Continuity of care suffers. When agencies don’t see the full picture, authorizations, referrals, and reimbursements get messy — translating into canceled appointments or surprise bills.
- Policy choices flow from data. RAND’s bottom line is clear: better data integration (VHA + Medicare + TRICARE + private claims) is needed to stop paying twice and to steer veterans to the right door faster.
What RAND (and Others) Recommend
- Integrate claims data across payers. Use Medicare, TRICARE, Medicaid, and private-plan claims alongside VA enrollment/utilization data to see where care actually happened — and who should pay.
- Educate veterans on coverage interactions. Clearer guidance on when to use VHA, community care, Medicare/MA, or private plans reduces accidental double billing.
- Sustain the VA–CMS data-matching push. Early findings show it works; scaling it can prevent new overpayments instead of chasing them later.
What You Can Do Right Now …
- Check your explanations of benefits (EOBs). If you use VA community care and also have Medicare or a private plan, scan EOBs for the same date of service showing up twice. If it looks wrong, report it to your VA community care office. (The VA has provider-billing guidance and audit processes in place.)
- Tell providers up front. Hand them your VA authorization (for community care) and make it crystal-clear not to bill Medicare for that visit. This reduces “we billed both to be safe” misfires.
- If you’re on Medicare Advantage, ask questions. Clarify how your MA plan interacts with VA care and prescriptions so you don’t pay premiums for benefits you rarely use — and so taxpayers aren’t paying twice.
Final thoughts …
Cutting waste isn’t anti-veteran — it’s pro-veteran. The 84% overlap is reality; the solution is smarter data, clearer rules, and consistent education, not finger-pointing. If VA, CMS, TRICARE, and private insurers pull in the same direction, the dollars saved can be redirected to what matters: faster decisions, steadier staffing, and better care for disabled veterans.
For more updates that actually move the needle, visit DisabledVeterans.org.
3/4 dip for the bloated wreck of a jobs program, the VHA, and 1/4 dip for actual healthcare for veterans. You notice all the so called treatments for spinal conditions listed on their website? Surgery isn’t on there. All that bullshit is part of the surgery avoidance scam. It’s the never ending flaming hoops they send people through to avoid solving the underlying cause of pain. This should be one of the biggest scandals ever but it’s cleverly covered up with lies and excused through talking for hours.
Need to get Congress to authorize some other avenue of Healthcare for veterans for those veterans who the VHA has made their healthcare at VA untenable. I’m serious. Some people shouldn’t be expected to go back there after they were trashed by the retaliation and denial of care over and over again. It’s inhumane.
VHA is a failed jobs program that needs to be eliminated so veterans can get full healthcare.
when has “saving taxpayer money” ever resulted in that savings being reinvested in quality of care?
i’ll go ahead and answer that for you. never.
it’s never happened. could it? sure, theoretically. but has it ever? no.
y’all have plenty of resources at your disposal to know this, and yet you choose to be Pollyanna about the system.
these articles are becoming more and more useless and i’m wondering what it is you think you are contributing at this point.
I was in physical and mental pain. They were simply using everything that came out of my mouth to spin it into a narrative that would degrade me and disqualify me from healthcare. I will sue these mother fuckers for human rights violation. If that doesn’t work, justice still must be done, I’m holding court in the streets.💀
same here. if only the VA didn’t work harder to enforce and intensify our alienation than it does to actually take care of us. they do not want us to talk to one another, they do not want us to come together because that would pose a legit threat to their impunity. we are so much easier to dismiss, discount, discredit, and destroy as individuals.
Rhett Puder was a son of a bitch. Rhett Puder was a fraud. Rhett Puder was a liar. Rhett Puder was a character assassination. Rhett Puder will burn in hell.🔥
That crooked organization is just hoarding tax payer money and building clinics instead of providing people with medically necessary procedures. People have left, people have died, people have suffered greatly. It’s time to end this jobs program full of mentally ill incompetents. Its reputation just gets worse every 5 years.
VHA autocrats declaring people threats, dangers, enemies of humanity and the US government, calling cops on people, trying to throw a wrench in their healthcare and benefits, all of this is lawlessness, incompetence, human rights violations, constitutional rights violations, have the courts gone away totally?
VHA employees make bogus claims, absurd assumptions, irrational conclusions, false narratives, outlandish accusations, it’s like Pinocchio’s Donkey Island. It’s a jobs program for insubordinate people who believe they can’t be sued or fired. By God you can’t have that sort of healthcare environment. Maybe in something like waste management but for Christ sakes not healthcare.
Isn’t it strange how the VA will service connect pain and then only half ass treat pain while denying responsibility for treating the underlying causes? You wondered why they wouldn’t service connect the underlying cause? You will see when the denial of care comes into play. The VA is a system of neglect, excuses, diversions, games, underhanded tactics, and all of this causes pain, suffering, and death. They should be sued out of existence.
– VA denying care for medically necessary procedures making insurance a must for people with things like spine conditions
– VA not giving pain medication so people must go outside
– VA character assassination and lies in medical records, retaliation, wait times, games, substandard care
The verdict: VHA is a bad system that needs to be replaced with an insurance program. Use the money spent on the bloated wreck on healthcare for veterans instead.