JBSA-FORT SAM HOUSTON -- In a move that helps veterans, and active-duty military patients and their families, local Veterans Affairs, or VA, and military medical facilities have dramatically increased their work-share agreements over the past two years and are seeking to add more.

Brooke Army Medical Center, or BAMC, the Air Force's 59th Medical Wing and the South Texas Veterans Health Care System, or STVHCS, have a combined 15 sharing agreements that give patients quicker access to health care by redirecting them to treatment facilities with convenient appointment slots.

Current agreements between BAMC and STVHCS cover a wide range of services including equipment sterilization, medical services, surgical services, the Integrated Disability Evaluation System, or IDES, transition services at the Center for the Intrepid, and ear, nose and throat, or ENT, surgery.

For BAMC, the most recently approved sharing agreement covers ENT surgical services, where the number of VA patients seen has increased dramatically since October 2013.

"The services provided and workload performed under these sharing agreements provides valuable wartime skill sustainment for DoD medical professionals, fuels 37 graduate medical education programs, enhances access to care for VA beneficiaries while simultaneously optimizing federal funding," said Col. Evan M. Renz, BAMC commander.

Agreements cover surgical services including but not limited to general surgery, ear nose and throat, gynecology and orthopedic surgery.

Similar agreements between the 59th Medical Wing and STVHCS cover blood bank services, sterilization, IDES, radiation oncology, surgical supervision, and medical services including but not limited to endoscopic ultrasound, sleep studies, dermatology laser treatments, and dialysis treatments.

Patients with access to the 59th Medical Wing's North Central Federal Clinic also benefit from the program.

"Work share agreements between the VA, BAMC and the 59th Medical Wing improves efficiency and effectiveness across a multitude of military healthcare services," said Maj. Gen. Bart Iddins, 59th Medical Wing commander.

"We are saving taxpayer dollars at a time when responsible stewardship of government resources is paramount. Appointment slots, that would otherwise remain vacant, are now filled," Iddins said. "Military medicine is focused on providing world-class, high quality, safe healthcare to our number one customer - the patient. We remain patient-centered in all we do, and work share agreements bolster this commitment."

Looking ahead, the San Antonio Military Health System, which integrates Army and Air Force health care services in the local area, is discussing several potential new agreements with local VA facilities.

These include expanded OB/GYN services - STVHCS is paying for newborn deliveries at civilian medical facilities. BAMC has the capacity to perform this work and the increased number of deliveries would be valuable for the OB/GYN residency program. Talks are progressing. The organizations have agreed in principle and now must work out the details, draft the agreement, and submit for approval.

Other areas being discussed for possible work-sharing include radiology services, vascular surgery, inpatient behavioral health, and hyperbaric oxygen therapy.

"South Texas Veterans Health Care System has a strong partnership with DoD, and we look forward to pursuing other opportunities in the future to continue to provide the best health care possible to both VA and DoD beneficiaries," said Dr. Julianne Flynn, STVHCS chief of staff.

There are also discussions for sharing initiatives with the Texas Valley Coastal Bend Veterans Health Care System, which could potentially involve the provision of surgical and medical services to VA patients living south of San Antonio.

This VA system covers a large, mostly rural area with a shortage of civilian specialty and sub-specialty providers. Talks are still in the early stages, but BAMC has agreed to take cases as space permits on a fee-for-service reimbursement method according to federal fee schedules.