And researchers say recently passed reforms to VA’s community care programs won’t fix those lengthy waits without dramatic improvements in data collection and monitoring of those outside care appointments.
“Ignoring these lessons learned and the challenges that have arisen under the Choice Program as (VA officials) design the future consolidated program would only increase VA’s risk for not being able to ensure that all veterans will receive timely access to care in the community,” their report stated.
The findings come just two days before President Donald Trump is expected to sign into law a $52 billion veterans policy measure (dubbed the VA Mission Act) which includes a consolidation and overhaul of separate and sometimes competing outside care programs. Work is expected to take another year before the new single program is operational.
The replacement system will mean an end to the VA Choice program, a controversial measure approved by Congress in 2014 with the goal of more quickly getting veterans into physician’s offices.
Lawmakers overwhelmingly approved the program in the wake of the department’s wait times scandal, where local administrators were found to be manipulating patient records to hide growing wait times for appointments and collect performance bonuses.
Veterans who face a wait of more than 30 days are eligible for the Choice program, but critics have complained that the system is overly bureaucratic and still places limits on veterans’ access to private-sector doctors at taxpayers’ expense.
But the new GAO research says that Choice participants can face waits of up to 70 days to receive care, due to bureaucratic requirements and deadlines. Officials there said VA’s decision not to put stricter timelines for patient requests lead to an average of 51 days for veterans to receive care in late 2016.
“Timeliness of appointments is an essential component of quality health care,” the report stated. “Delays in care have been shown to negatively affect patients’ morbidity, mortality, and quality of life… VA lacks assurance that veterans are receiving care from community providers in a timely manner.”
VA officials have said they have improved those program delays over the last year, but also insisted that fixing the system will require a complete overhaul of the community care offerings.
The report recommends new wait-time monitoring systems for the outside appointments and including better timeliness requirements in future program guidelines. VA officials in a response letter agreed with most of the findings, and said they will be incorporated in their work over the coming year.
The new legislation Trump is expected to sign into law this week includes $5.2 billion to keep the Choice program operational into early 2019. Department officials have said the program funds roughly 30,000 appointments a day.
The full report is available on the GAO web site.