Veterans

VA’s next medical challenge: catching up on millions of missed veterans’ appointments

Veterans Affairs officials still have millions of coronavirus vaccines to distribute in coming months, but they are already warily eyeing the next massive medical challenge to follow: making up millions of medical appointments for veterans who have put off routine and specialty care because of virus concerns.

“We’ve had massive amounts of health care deferred,” said acting VA Under Secretary for Health Richard Stone in an interview with Military Times on Wednesday. “We’re down almost 12,000 surgeries a month from before the pandemic. And have to be able to look after those who need us when they come back.”

Federal medical experts have estimated that as many as 41 percent of Americans have deferred regular check-ups or non-emergency care visits since last spring, when public officials ordered business closures and stay-at-home orders in an effort to contain the spread of COVID-19.

VA officials said that they have made up some of those lost appointments through telehealth. In a roundtable with reporters this week, VA Secretary Denis McDonough said that the number of online appointments has increased almost 20-fold in the last year, from 2,500 a day last March to 45,000 a day this month.

“But we’re still looking at delayed or deferred care of more than 19 million appointments,” he said. “And some of that delayed care is going to be more costly than it has been in the past.”

Department leaders are highlighting those new expenses as part of their campaign for President Joe Biden’s coronavirus relief package, under debate on Capitol Hill. The $1.9 trillion plan includes about $15 billion in new VA spending, money that some conservatives have argued could be deferred until next fiscal year, and considered in the normal budgeting process.

McDonough dismissed that assessment.

“I wish we had the ability to just let this be an issue out over the horizon,” he said. “But with telehealth, we need additional information technology investments now to respond to the demand, including more hardware and software for vets. And we don’t know exactly when all those other [in-person] appointments will come back.”

Stone said medical officials are already preparing for the flood of rescheduled appointments. At the height of the pandemic, about 6,000 workers a day were unable to work because of contract tracing or personal illness. That number is down to around 1,000 a day now, effectively giving VA an influx of extra workers to handle rising patient demands.

He said that as veterans receive vaccines, they are also being informed of services that have reopened (to make up for missed medical appointments) and of other resources available to them. That’s particularly important for individuals who may be facing new mental health issues from the stress and isolation of the pandemic.

“This isn’t something that will just be over,” he said. “We recognize that we’re going to be dealing with the effects of this pandemic probably for the next few years.”

The vaccine effort shouldn’t take nearly as long. In the first few weeks of vaccine distribution, VA was administering about 104,000 doses a week. Now they’re up to about 194,000 each week, Stone said, with the capability of going even higher.

Stone was in New York this week taking part in a mass vaccination event as part of the department’s Fourth Mission responsibilities, to act as a backup system for American health care. VA staff administered vaccines to about 1,500 locals, from a separate supply from their doses for veterans and staff.

“When vaccines are available from our federal partners, we’re at the front of the line asking for more,” he said. “They’re seeing that we can get it into people’s arms quickly, so that has helped us get more.”

Nearly 10,600 VA patients have died from coronavirus complications in the last year. Nationwide, nearly 520,000 Americans have died from medical issues linked to the virus.

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