VA Health Care: Additional Assessments of Mileage Reimbursem*nt Data and Veterans' Travel Costs Needed (2024)

The Veterans Health Administration's mileage reimbursem*nt benefit helps defray costs for eligible veterans who travel to receive medical care.

Veterans' use of the benefit declined during the COVID-19 pandemic when VHA shifted most care to telehealth. However, VHA doesn't know how different types of veterans use the benefit—which may be useful. For example, VHA may want to determine how often rural veterans use the benefit to access in-person care, as they tend to be less likely to have the broadband access necessary to access telehealth care.

We recommended, among other things, that VHA collect and assess this information.

VHA’s Mileage Reimbursem*nt Claims, FYs 2010-2023

What GAO Found

The Veterans Health Administration (VHA) uses the mileage reimbursem*nt benefit to reimburse eligible veterans for use of personal vehicles to attend VHA-approved care. The benefit comprises (1) the mileage reimbursem*nt rate—a per-mile amount VHA reimburses beneficiaries for travel to and from approved care and (2) a deductible—the amount VHA withholds from reimbursem*nts with the purpose of limiting program costs.

According to officials, VHA tracks national trends of veterans' benefit use overall, but does not collect this information for subpopulations of veterans. GAO's analysis of VHA data show that veterans' use of the benefit increased from fiscal years 2010 through 2019 before declining in fiscal year 2020. In the last two fiscal years use increased, but remains below its peak. VHA officials attributed the decline to VHA's shift to telehealth in response to the COVID-19 pandemic. However, VHA does not collect information on how underserved subpopulations of veterans, such as rural veterans, use the benefit. This information could help VHA assess how changes in benefit use caused by the pandemic may have affected groups of veterans differently, which could help VHA determine how to address potential inequities. For example, VHA may want to determine how often rural veterans use the benefit to access in-person care, as they tend to be less likely to have the broadband access necessary to access telehealth care.

VHA has some information on travel costs for which veterans request reimbursem*nt, such as tolls. However, VHA does not collect information on other travel costs, such as fuel costs, or assess how travel costs may vary across veteran subpopulations. Although VHA's reimbursem*nt rate is set in statute, collecting additional travel cost information and assessing costs by subpopulations could inform future revisions to VHA's transportation programs aimed at optimizing their assistance for veterans. For example, VHA could use the information to revise the current eligibility model to consider travel to highly rural facilities for care.

GAO found, after the deductible, a veteran must travel at least 15 miles round trip to receive a reimbursem*nt and 25 miles to have fuel costs covered.

A Veteran's Mileage Reimbursem*nt per Mile Traveled Compared to Fuel Costs

Note: Reimbursem*nt is based on the current mileage reimbursem*nt rate of 41.5 cents per mile and a $6 round-trip deductible. The analysis assumes no other costs, such as maintenance, were incurred. GAO used the average fuel price in August 2023 of $3.95 per gallon and a fuel efficiency of 22.9 miles per gallon, the 2021 average fuel efficiency for light-duty vehicles.

Why GAO Did This Study

According to VHA, veterans' access to care is a multifaceted issue, and one in which disparities persist. VHA tries to improve access through the mileage reimbursem*nt benefit, whose purpose is to defray beneficiaries' travel costs.

The Consolidated Appropriations Act, 2023, includes a provision for GAO to examine the Department of Veterans Affairs (VA) mileage reimbursem*nt benefit. This report examines the information VHA has on veterans' use of the benefit and on veterans' travel costs, among other objectives.

GAO reviewed the VHA directive outlining VHA's requirements for administering the benefit and VHA data on veterans' use of the benefit from fiscal years 2010 through 2023. GAO also interviewed VHA officials who oversee the benefit; officials from three VHA health care systems, selected for variation in geography, among other things; and representatives from four veterans service organizations. Using fuel costs, GAO also analyzed the current rate and deductible to determine the distance a veteran would have to travel to receive a non-zero reimbursem*nt.

Access to health careBeneficiariesInsurance deductibleReimbursem*nt claimsTravel costsVeteransVeterans health careHealth care systemsEnergy costsHealth care