1.0 Background

The Health Care Benefits Program provides eligible Veterans and other qualified recipients with funding to access necessary health care benefits (also referred to as treatment benefits). The program is comprised of fourteen categories of benefits and services and within those categories, there are hundreds of individual treatment benefits which Veterans can access. In 2017–18, program expenditures totaled $299.6 Million and there were almost 79,000^{Footnote 1} Veterans accessing benefits. The program is administered by Veterans Affairs Canada (VAC) field office staff and through a third party health care processor with support from numerous areas within VAC. The program management unit is responsible for the management of the program. A brief overview of the benefits and services provided through each of the fourteen categories of Programs of Choice (POCs) is included in Appendix B.

As part of the Health Care Benefits Program VAC introduced multi-disciplinary clinics (MDCs) in 2012 and they are included in POC 5 – Hospital Services. Multi-disciplinary clinics are comprised of various health professionals and para-professionals such as physicians, psychologists, physiotherapists, social workers, kinesiologists, and recreational therapists. The expectation is that the MDC staff provides a coordinated team approach to assessing and treating those with complex health problems and treatment objectives.^{Footnote 2}

Initially, in 2012, there were four facilities registered and in 2014, the department began registering a broader range of facilities which provided integrated multi-disciplinary care to eligible Veterans and other clients.^{Footnote 3} As of March 31, 2019, there were 227 MDCs registered with the department with 55 additional applications for registration awaiting a decision. There have been 372 applications to the program in total with 86 applications declined. Of the clinics approved for registration with VAC, 185 are outpatient, 26 are inpatient, and 16 are combination clinics with both inpatient and outpatient services available. For inpatient treatment, Veterans reside at the facility for the duration of their treatment. Outpatient treatment requires no overnight stay.

MDC expenditures are increasing consistently year over year. As illustrated in Figure 1, total MDC expenditures in 2015-16 were approximately $6 million and by 2017-18 expenditures had increased to over $12 million.^{Footnote 4} Although MDC program costs have increased significantly, the cost per individual program recipient has remained fairly constant. The increase in program costs have been driven by volume, both in the number of MDC clinics and the number of individual program recipients.

Source: VAC Statistics Directorate, request 1185 with data analysis by VAC Audit and Evaluation Division