The first of these analyses – the study of the personal impact of the teaching function inherent in membership agreements – was an integral part of the overall methodology described in Chapters 4 to 6. This chapter examines further the impact of membership agreements on physician staffing needs, as well as issues related to the cost and quality of care provided to Veterans. As part of the development of these innovative approaches to belonging, the VA should explore building relationships with other medical institutions in addition to medical schools. The VA has already created the beginnings of a new model of membership in a recently implemented program, involving community-based health facilities that are not primarily tied to medical schools. These agreements, hourly, are in line with the intention to extend membership objectives beyond access to the most modern emergency and tertiary services. The Committee believes that this expansion is an exciting opportunity for AA, which could help to meet some of the staffing requirements that could be determined by applying the proposed methodology for the needs of physicians. When the Office of General Counsel (OGC) will have to re-examine a membership agreement: again, the Committee notes that since many VAMs are so closely linked to the medical environments of higher education care, it is possible that particular attention may need to be paid to solving certain problems with the typical model of care of the teaching environment. WHQR 91.3 History – „UNCW and Fayetteville VA Medical Center Sign Membership Agreement“ An inventory of clinical activities in VAMCs was conducted in 1990 by the Commission on the Future Structure of Veterans Health Care, an independent advisory group created by the VA to recommend future strategies for its health system. The inventory showed that connected VAMs tend to have a much wider choice of services for their patients. In particular, this inventory showed that the concentration of high-tech services (the type usually associated with tertiary care) was very high in affiliated hospitals (Table 9.4). Although such services could be provided in another way, the pervasive nature of affiliation agreements would require a very substantial change to the current rules. And any proposed change would have to bear the burden of proof that the alternative approach would also fulfill the task.
When an agreement has been proposed by a mediation body. However, it is also reported that the positive value and potential for new directions in membership, especially from unaffiliated hospitals, is increasingly recognized. . . .