36C10G19R0041-003.docx

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Microsoft_Excel_Worksheet.xlsx Sheet1

From Year 2011 2011 2011

To Year 2012 2012 2012

Current Policy Scenario BY11 Model BY11 Model BY11 Model BY11 Model BY11 Model BY11 Model

Svc Category for Current Policy Projection Total_NoLTC LTC Total_wLTC

Trend Scenario 1 Utilization Trend Inflation Trend Intensity Trend

Trend Scenario 2 Civilian Wage Freeze

Trend Scenario 3

ATTACHMENT C

Budget Impact Analysis

Department of Veterans Affairs

2102 Model (BY11) Scenario Z

ANNUAL Expenditure Impacts from FY AAAA to FY BBBB (millions)

BYXX Scenario X Projected Expenditure Impacts

FY AAAA to FY BBBB Change

Expenditures ($millions) % Change

Modeled Services Excluding LTC Modeled LTC All Modeled Services Modeled Services Excluding LTC Modeled LTC All Modeled Services

FY AAAA Projection XX,XXX X,XXX XX,XXX

SvcCat w/o LTC LTC SvcCat Impact Scenario Clinical Efficiencies

IP Management Improvement Inpatient Medicine and Surgery1 XXX - 0 XXX X.XX% - 0 X.XX%

Amb Management Improvement Ambulatory Services1 XXX - 0 XXX X.XX% - 0 X.XX%

MH Management Improvement Mental Health (Inpatient and Outpatient)1 XXX - 0 XXX X.XX% - 0 X.XX%

Rx Management Improvement Pharmacy1 XXX - 0 XXX X.XX% - 0 X.XX%

Total_NoLTC LTC Management Improvement Clinical Efficiencies Total1 XXX - 0 XXX X.XX% - 0 X.XX%

Mental Health Initiative Detail X.XX% X.XX%

MH Mental Health & Homeless Capacity Improvement Policies - Utilization Component MH Utilization Impact1 153 - 0 153 X.XX% - 0 X.XX%

MH Mental Health & Homeless Capacity Improvement Policies - Unit Cost Component MH Unit Cost Impact1 19 - 0 19 X.XX% - 0 X.XX%

MH Mental Health & Homeless Capacity Improvement Policies Mental Health Initiative1 XXX - 0 XXX X.XX% - 0 X.XX%

Homeless Mental Health & Homeless Capacity Improvement Policies - Utilization Component Homeless Initiative1 XXX - 0 XXX X.XX% - 0 X.XX%

Pharmacy Cost Efficiencies (See trends below) X.XX% X.XX%

X.XX% X.XX%

Dental Dental, PACT, Glasses, Hearing Aid Capacity Improvement Policies Dental Capacity Expansion1 XXX - 0 XXX X.XX% - 0 X.XX%

PACT_NonLTC PACT_LTC Dental, PACT, Glasses, Hearing Aid Capacity Improvement Policies PACT Initiative1 - 0 XXX XXX X.XX% X.XX% X.XX%

Long-Term Care Initiative Detail X.XX% X.XX% X.XX%

Total_NoLTC LTC Long-Term Care Initiative - Utilization Component Long-Term Care Utilization1 0 78 78 X.XX% X.XX% X.XX%

Total_NoLTC LTC Long-Term Care Initiative - Unit Cost Component Long-Term Care Unit Cost1 - 0 40 40 X.XX% X.XX% X.XX%

Total_NoLTC LTC Long-Term Care Initiative Long-Term Care Initiative1 XXX XXX XXX X.XX% X.XX% X.XX%

Economic Conditions (Recession & Recovery)

Total_NoLTC LTC Recession - Reliance Behavior Changes Reliance Behavior1 XXX - 0 XXX X.XX% - 0 X.XX%

Enrollment Behavior (See below)

Enrollment Growth & Demographic Mix Changes X.XX% X.XX% X.XX%

Total_NoLTC LTC Enrollment Growth - Net New Enrollment Enrollment Growth - Net New Enrollment 244 (340) (96) X.XX% X.XX% X.XX%

Total_NoLTC LTC Enrollment Growth - New Enrollment Utilization Impact Impact of Duration Since Enrollment (87) 0 (87) X.XX% X.XX% X.XX%

Duration Transitions Net Enrollment Growth w/ Duration XXX XXX XXX X.XX% X.XX% X.XX%

XXX XXX X.XX% X.XX% X.XX%

Total_NoLTC LTC Priority Transitions Priority Level Transitions XXX 161 XXX X.XX% X.XX% X.XX%

Total_NoLTC LTC Morbidity Transitions Morbidity Transitions (LTC is different) XXX - 0 XXX X.XX% X.XX% X.XX%

Priority Level & Morbidity Transitions XXX XXX XXX X.XX% X.XX% X.XX%

XXX XXX XXX X.XX% X.XX% X.XX%

Total_NoLTC LTC Geographic Migration Geographic Migration XXX XXX XXX X.XX% X.XX% X.XX%

XXX XXX XXX X.XX% X.XX% X.XX%

Total_NoLTC LTC Aging Impact Aging Impact XXX XXX XXX X.XX% X.XX% X.XX%

Total_NoLTC LTC Duration Transitions XXX XXX X.XX% X.XX% X.XX%

Total_NoLTC LTC Recession - Enrollment Behavior - Long Term Econ to Permanent Recession Economic Enrollment Behavior - Ongoing Recession1 246 XXX XXX X.XX% X.XX% X.XX%

Total_NoLTC LTC Recession - Enrollment Behavior - Permanent Recession to Current Policy Economic Enrollment Behavior - Recovery1 (51) XXX XXX X.XX% X.XX% X.XX%

Economic Enrollment Behavior1 XXX XXX XXX X.XX% X.XX% X.XX%

X.XX% X.XX% X.XX%

Total_NoLTC LTC Net Enrollment Growth & Demographic Mix Changes Net Enrollment Growth & Demographic Mix Changes XXX XXX XXX X.XX% X.XX% X.XX%

Total_NoLTC LTC Utilization Trend Utilization Trend XXX XXX XXX X.XX% X.XX% X.XX%

Inflation Trend

Total_NoLTC LTC Inflation Trend Base Trend (Before Wage Freeze) XXX XXX XXX X.XX% X.XX% X.XX%

Total_NoLTC LTC Civilian Wage Freeze Civilian Wage Freeze1 XXX XXX XXX X.XX% X.XX% X.XX%

Inflation Trend XXX XXX XXX X.XX% X.XX% X.XX%

Total_NoLTC LTC Intensity Trend Intensity Trend XXX - 0 XXX X.XX% - 0 X.XX%

Total_NoLTC LTC Pharmacy Copay Schedule Changes Pharmacy Copay Schedule Changes XXX - 0 XXX X.XX% - 0 X.XX%

Total_NoLTC LTC Net Value of Budget Items Net Value of Budget Items (387) 133 (254) X.XX% X.XX% X.XX%

Interaction Impact1 XXX XXX XXX X.XX% X.XX% X.XX%

Total Change X,XXX XXX X,XXX X.XX% X.XX% X.XX%

FY BBBB Projection XX,XXX X,XXX XX,XXX

Trends by Service Category - FY AAAA to FY BBBB

Expenditure Change ($millions) Trend 2

Service Category Utilization Trend Inflation Trend Intensity Trend Utilization Trend Inflation Trend Intensity Trend

Total_wLTC All Services XXX XXX XXX X.XX% X.XX% X.XX%

Amb Ambulatory Services XXX XXX XXX X.XX% X.XX% X.XX%

IP Inpatient Medicine and Surgery XXX XXX XXX X.XX% X.XX% X.XX%

MH Mental Health (Inpatient and Outpatient) XXX XXX XXX X.XX% X.XX% X.XX%

LTC Long-Term Care XXX XXX XXX X.XX% X.XX% X.XX%

Rx Pharmacy XXX XXX XXX X.XX% X.XX% X.XX%

Prosth Prosthetics XXX XXX XXX X.XX% X.XX% X.XX%

Other Other XXX XXX XXX X.XX% X.XX% X.XX%

1 These budget items also include the annual impacts associated with all of the other factors (Net Enrollment Growth, Priority Level Transition, Geographic Migration, Mix Changes, and all Trend and benefit change components).

2 Estimated annual trend in the Model for these service categories. The trends for the detailed service categories do not sum to the All Services trend because they are calculated relative to the projected expenditures for only that service category (e.g. the ambulatory trend reflects the estimated expenditure change due to ambulatory service trends relative to the projected expenditures for ambulatory services).

Sheet2

Sheet3