,i  #aag? ,,congress  #a/ ,session  ,h4 
,r4 #dfbf  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,july #bb1 #bjba,mr4  
,b]gman 7= himself & ,mr4 ,bo/7         
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,vet]ans' ,affairs  ,a 
,,bill  ,to am5d title #ch1 ,unit$      
,/ates ,code1 to require an indep5d5t   
assessm5t ( heal? c>e deliv]y sy/ems &  
managem5t processes ( ! ,dep>tm5t (     
,vet]ans ,affairs be conduct$ once e #aj
 ye>s1 & = o!r purposes4  #a4 ,%ort     
title ,?is ,act may be cit$ z ! ,,va    
,assessm5t by ,indep5d5t ,measures ,act 
or ! ,,va ,,aim ,act4  #b4 ,requirem5t =
 ongo+ indep5d5t assessm5ts ( heal? c>e 
deliv]y sy/ems & managem5t processes ( !
 ,dep>tm5t ( ,vet]ans ,affairs  7a7     
,ongo+ assessm5ts ,*apt] #ag ( title    
#ch1 ,unit$ ,/ates ,code1 is am5d$ by   
ins]t+ aft] section #agjd ! foll[+ ! new
 section3  #agjd;,a4 ,indep5d5t         
assessm5ts ( heal? c>e deliv]y sy/ems & 
managem5t processes  7a7 ,indep5d5t     
assessm5ts ,n less frequ5tly ?an once e 

#aj ye>s1 ! ,secret>y ( ,vet]ans        
,affairs %all ent] into "o or m         
contracts ) a private sector entity or  
entities describ$ 9 subsection 7e7 to   
conduct an indep5d5t assessm5t ( !      
hospital c>e1 m$ical s]vices1 & o!r     
heal? c>e furni%$ by ! ,dep>tm5t (      
,vet]ans ,affairs4 ,su* assessm5t %all  
address ea* ( ! foll[+3 7#a7 ,curr5t &  
project$ demographics & unique heal? c>e
 ne$s ( ! pati5t population s]v$ by !   
,dep>tm5t4  7#b7 ,! accuracy ( models & 
=eca/+ me?ods us$ by ! ,dep>tm5t to     
project heal? c>e dem&1 includ+ )       
respect to vet]an demographics1 rates ( 
use ( heal? c>e furni%$ by ! ,dep>tm5t1 
! inflation ( heal? c>e co/s1 & su* o!r 
factors z may be det]m9$ relevant by !  
,secret>y4  7#c7 ,budget>y tr5ds ( !    
,dep>tm5t affect+ ! provision ( heal?   
c>e to vet]ans1 includ+ a review (      
curr5t & project$ heal? c>e             
capabilities1 res\rces1 & ne$s ( !      
,dep>tm5t & ( ! reliability & accuracy (
 models & =eca/+ me?ods us$ by !        

,dep>tm5t to project ! budget>y ne$s ( !
 ,vet]ans ,heal? ,adm9i/ration4  7#d7 ,!
 au?orities & me*anisms "u :i* !        
,secret>y may furni% hospital c>e1      
m$ical s]vices1 & o!r heal? c>e at      
non-,dep>tm5t facilities1 includ+ ?r\gh 
,f$]al & private sector p>tn]s & at jo9t
 m$ical facilities4  7#e7 ,! appropriate
 sy/em-wide access applicable to        
hospital c>e1 m$ical s]vices1 & o!r     
heal? c>e furni%$ by & ?r\gh !          
,dep>tm5t1 includ+ an id5tification ( ! 
appropriate access = ea* individual     
specialty & po/-c>e rehabilitation )    
respect to vet]ans & eligible           
non-vet]ans4  7#f7 ,! workfl[ process at
 ea* m$ical facility ( ! ,dep>tm5t =    
s*$ul+ appo9tm5ts = vet]ans to receive  
hospital c>e1 m$ical s]vices1 or o!r    
heal? c>e f ! ,dep>tm5t4  7#g7 ,!       
organization1 workfl[ processes1 & tools
 us$ by ! ,dep>tm5t to support cl9ical  
/aff+1 access to c>e1 effective         
l5g?-(-/ay managem5t & c>e transitions1 
positive pati5t exp]i5ce1 accurate      

docum5tation1 & subsequ5t cod+ (        
inpati5t s]vices4  7#h7 ,! ef=ts ( !    
,dep>tm5t to recruit & reta9 /aff at    
levels necess>y to c>ry out ! functions 
( ! ,vet]ans ,heal? ,adm9i/ration & !   
process us$ by ! ,dep>tm5t to det]m9e   
/aff+ levels necess>y = su* functions4  
7#i7 ,! /aff+ level at ea* m$ical       
facility ( ! ,dep>tm5t & ! productivity 
( ea* heal? c>e provid] at ! m$ical     
facility1 comp>$ ) heal? c>e indu/ry    
p]=mance metrics1 :i* may include !     
foll[+3 7,a7 ,an assessm5t ( ! case load
 (1 & numb] ( pati5ts treat$ by1 ea*    
heal? c>e provid] at su* m$ical facility
 dur+ an av]age week4  7,b7 ,an         
assessm5t ( ! "t sp5t by ea* su* heal?  
c>e provid] on matt]s o!r ?an ! case    
load ( ! heal? c>e provid]1 includ+ "t  
sp5t by ! heal? c>e provid] z foll[s3   
7i7 ,at a m$ical facility t is affiliat$
 ) ! ,dep>tm5t4  7ii7 ,conduct+ rese>*4 
7iii7 ,tra9+ or sup]vis+ o!r heal? c>e  
pr(essionals ( ! ,dep>tm5t4  7#aj7 ,!   
in=mation te*nology /rategies ( !       

,dep>tm5t ) respect to furni%+ & manag+ 
heal? c>e1 includ+ an id5tification (   
any weaknesses or opportunities )       
respect to ! te*nology us$ by !         
,dep>tm5t1 especially ^? /rategies )    
respect to cl9ical docum5tation (       
hospital c>e1 m$ical s]vices1 & o!r     
heal? c>e1 includ+ any cl9ical images & 
associat$ textual reports1 furni%$ by ! 
,dep>tm5t 9 ,dep>tm5t or non-,dep>tm5t  
facilities4  7#aa7 ,bus9ess processes ( 
! ,vet]ans ,heal? ,adm9i/ration1 includ+
 processes relat+ to furni%+            
non-,dep>tm5t heal? c>e1 insurance      
id5tification1 ?ird-p>ty rev5ue         
collection1 & v5dor reimbursem5t1       
includ+ an id5tification ( me*anisms z  
foll[s3 7,a7 ,to avoid ! paym5t (       
p5alties to v5dors4  7,b7 ,to increase !
 collection ( am\nts ow$ to ! ,dep>tm5t 
= hospital c>e1 m$ical s]vices1 or o!r  
heal? c>e provid$ by ! ,dep>tm5t1 = :i* 
reimbursem5t f a ?ird p>ty is au?oriz$ &
 to ensure t su* am\nts collect$ are    
accurate4  7,c7 ,to increase !          

collection ( any o!r am\nts ow$ to !    
,dep>tm5t ) respect to hospital c>e1    
m$ical s]vices1 or o!r heal? c>e & to   
ensure t su* am\nts collect$ are        
accurate4  7,d7 ,to increase ! accuracy 
& timel9ess ( ,dep>tm5t paym5ts to      
v5dors & provid]s4  7,e7 ,to r$uce      
exp5ditures :ile improv+ ! quality ( c>e
 furni%$4  7#ab7 ,! pur*ase1            
di/ribution1 & use ( ph>maceuticals1    
m$ical & surgical supplies1 m$ical      
devices1 & heal? c>e relat$ s]vices by !
 ,dep>tm5t1 includ+ ! foll[+3 7,a7 ,!   
prices paid =1 /&>dization (1 & use by1 
! ,dep>tm5t ) respect to ! foll[+3 7i7  
,ph>maceuticals4  7ii7 ,m$ical &        
surgical supplies4  7iii7 ,m$ical       
devices4  7,b7 ,! use by ! ,dep>tm5t (  
gr\p pur*as+ arrangem5ts to pur*ase     
ph>maceuticals1 m$ical & surgical       
supplies1 m$ical devices1 & heal? c>e   
relat$ s]vices4  7,c7 ,! /rategy &      
sy/ems us$ by ! ,dep>tm5t to di/ribute  
ph>maceuticals1 m$ical & surgical       
supplies1 m$ical devices1 & heal? c>e   

relat$ s]vices to ,vet]ans ,integrat$   
,s]vice ,networks & m$ical facilities ( 
! ,dep>tm5t4  7#ac7 ,! process ( !      
,dep>tm5t = c>ry+ out con/ruction &     
ma9t5ance projects at m$ical facilities 
( ! ,dep>tm5t & ! m$ical facility leas+ 
program ( ! ,dep>tm5t4  7#ad7 ,!        
compet5cy ( ,dep>tm5t lead]%ip ) respect
 to culture1 acc\ntability1 re=m        
read9ess1 lead]%ip developm5t1 physician
 alignm5t1 employee engagem5t1          
succession plann+1 & p]=mance managem5t4
  7#ae7 ,! tra9+ ( heal? c>e p]sonnel ( 
! ,dep>tm5t4  7#af7 ,! conduct ( m$ical 
& pro/hetic rese>* ( ! ,dep>tm5t4  7#ag7
 ,! provision ( ,dep>tm5t assi/ance to  
,f$]al ag5cies & p]sonnel involv$ 9     
respond+ to a disa/] or em]g5cy4  7#ah7 
,su* additional matt]s z may be det]m9$ 
relevant by ! ,secret>y4  7b7 ,tim+ ,!  
private sector entity or entities c>ry+ 
out an assessm5t pursuant to subsection 
7a7 %all complete su* assessm5t n lat]  
?an "o ye> aft] ent]+ into ! contract   
describ$ 9 su* p>agraph4  7c7 ,private  

,sector ,entities ,describ$ ,a private  
entity describ$ 9 ?is subsection is a   
private entity t-- 7#a7 has exp]i5ce &  
prov5 outcomes 9 optimiz+ ! p]=mance ( !
 heal? c>e deliv]y sy/ems ( ! ,vet]ans  
,heal? ,adm9i/ration & ! private sector 
& 9 heal? c>e managem5t2 &  7#b7        
specializes 9 implem5t+ l>ge-scale      
organizational & cultural trans=mations1
 especially ) respect to heal? c>e      
deliv]y sy/ems4  7d7 ,program           
,integrator  7#a7 ,if ! ,secret>y ent]s 
into contracts ) m ?an "o private sector
 entity "u subsection 7a7 ) respect to a
 s+le assessm5t "u su* subsection1 !    
,secret>y %all designate "o su* entity t
 is pr$om9ately a heal? c>e organization
 z ! program integrator4  7#b7 ,!       
program integrator designat$ pursuant to
 p>agraph 7#a7 %all be responsible =    
coord9at+ ! outcomes ( ! assessm5ts     
conduct$ by ! private entities pursuant 
to su* contracts4  7e7 ,reports  7#a7 ,n
 lat] ?an #fj days aft] complet+ an     
assessm5t pursuant to subsection 7a71 ! 

private sector entity or entities c>ry+ 
out su* assessm5t %all submit to !      
,secret>y ( ,vet]ans ,affairs & !       
,committees on ,vet]ans' ,affairs ( !   
,h\se ( ,repres5tatives & ! ,s5ate a    
report on ! f9d+s & recomm5dations ( !  
private sector entity or entities )     
respect to su* assessm5t4 ,su* report   
%all include an id5tification ( !       
foll[+3 7,a7 ,any *anges ) respect to ! 
matt]s includ$ 9 su* assessm5t s9ce !   
date t is ! lat] ( ! foll[+3 7i7 ,! date
 on :i* ! indep5d5t assessm5t "u section
 #bja ( ! ,vet]ans ,access1 ,*oice1 &   
,acc\ntability ,act ( #bjad 7,public    
,law #aac-adf2 #ch ,u4,s4,c4 #agja note7
 0 complet$4  7ii7 ,! date on :i* ! la/ 
assessm5t "u subsection 7a7 0 complet$4 
7,b7 ,any recomm5dations reg>d+ matt]s  
to be cov]$ by subsequ5t assessm5ts "u  
subsection 7a71 includ+ any additional  
matt]s to include = assessm5t or        
previ\sly assess$ matt]s to exclude4    
7#b7 ,n lat] ?an #cj days aft] receiv+ a
 report "u p>agraph 7#a71 ! ,secret>y   

%all publi% su* report 9 ! ,f$]al       
,regi/] & on a publicly accessible      
int]net website ( ! ,dep>tm5t4  4  7b7  
,cl]ical am5dm5ts ,! table ( sections at
 ! beg9n+ ( su* *apt] is am5d$ by ins]t+
 aft] ! item relat+ to section #agjd !  
foll[+ new item3  #agjd;,a4 ,indep5d5t  
assessm5ts ( heal? c>e deliv]y sy/ems & 
managem5t processes4  4  7c7 ,deadl9e = 
initial assessm5t ,! initial assessm5t  
"u section #agjd;,a ( title #ch1 ,unit$ 
,/ates ,code1 z add$ by subsection 7a71 
%all be complet$ by n lat] ?an ,decemb] 
#ca1 #bjbe4