21 Jun GAO Highlights Issues with VA Care Ahead of Reforms
Fulfilling a provision set by the 2016 Consolidated Appropriations Act, the GAO has reviewed the Choice Program and found that the program is producing extended wait times for veterans, despite being originally developed to expedite care when it is not more immediately available through the VA. After analyzing a sample of care authorizations, GAO found that veterans could potentially be waiting up to 70 calendar days for care, which far exceeds the 30-day statutory requirement. GAO also found that the VHA has been collecting inaccurate and incomplete data on wait times for this program. A new study published in the Annals of Emergency Medicine shows a marked difference in emergency care staffing in rural areas as opposed to urban areas. This research shows the physician shortage has made a strong impact on rural emergency care.
GAO points to a number of factors contributing inefficacies in the Choice Program:
(1) complex referral and appointment scheduling processes
(2) poor communication between VHA and its VA Medical Centers (VAMCs)
(3) inadequate networks of community providers established by third-party administrators (TPAs), including an insufficient number, mix, or geographic distribution of community providers
The Choice Program will soon end and be consolidated with the VA’s other community care programs. GAO made several recommendations, directed toward the Under Secretary of Health, for these consolidated programs in light of the Choice Program’s shortcomings. More attention should be given to (1) designing and implementing achievable wait-time and appointment process benchmarks, (2) implementing better data collection and oversight mechanisms, and (3) establishing a system that will help facilitate efficient care coordination and exchanges of information among VAMCs, VHA clinicians, TPAs, community providers, and veterans.
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