Performance measurement and program evaluation

(a) Data collection The Secretary shall establish a performance measurement framework to evaluate whether the pilot program improves claimant outcomes, administrative efficiency, and access to long-term care services for veterans and surviving spouses applying for non-service-connected pension benefits, including aid and attendance. (b) Required performance measures The Secretary shall collect and evaluate, at a minimum— (1) the number of claimants participating in the pilot program; (2) the percentage of claims initially submitted as Fully Developed Claims; (3) the percentage of claims that remain in Fully Developed Claim status through final adjudication; (4) the rate of incomplete, deficient, or administratively rejected submissions compared to similar claims processed outside the pilot program; (5) the number and frequency of requests for additional evidence or development actions following submission; (6) measures of evidentiary completeness, including the presence of required financial, medical, dependency, and long-term care documentation at initial submission; (7) average claim processing times from submission to final decision compared to non-pilot claims; (8) claimant continuity measures, including claimant retention and successful completion of the claims-development process; (9) approval rates for claims processed through the pilot compared to similarly situated claims processed outside the pilot; (10) claimant access to home care, assisted living, nursing facility care, or other long-term care services following receipt of benefits; (11) the extent to which receipt of pension benefits through the pilot reduced, delayed, or avoided reliance on Medicaid-funded long-term care services; (12) claimant satisfaction and program accessibility measures; and (13) any additional measures the Secretary determines necessary to evaluate operational effectiveness and scalability. (c) Comparative analysis The Secretary shall compare pilot-program performance against substantially similar non-pilot pension claims to determine whether the pilot improves— (1) claim quality; (2) evidentiary completeness; (3) claimant outcomes; (4) administrative efficiency; (5) Fully Developed Claim retention rates; (6) access to long-term care services; and (7) reductions in Medicaid-funded long-term care utilization. (d) Preliminary report to Congress Not later than 30 days after the date that is 18 months after the commencement of the pilot program under section 3, the Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a preliminary report on the implementation and performance of the pilot program. (e) Report to Congress Not later than 180 days after completion of the pilot program, the Secretary shall submit a report to the Committees on Veterans’ Affairs of the House of Representatives and the Senate containing— (1) all performance data collected under this section; (2) an assessment of whether the pilot improved Fully Developed Claim retention, evidentiary completeness, claimant continuity, approval outcomes, and adjudication timelines; (3) an assessment of reductions in Medicaid-funded long-term care expenditures attributable to benefits obtained through the pilot; (4) recommendations regarding expansion, continuation, modification, or termination of the pilot; and (5) an assessment of the feasibility of expanding the pilot to additional jurisdictions or implementing the model on a nationwide basis.