VA outlines plans to address Government Accountability Office's concerns about its health system

The Department of Veterans Affairs has begun launching programs to address concerns raised by the Government Accountability Office's about its healthcare system, it announced Monday.

The GAO identified five specific risk areas that the VA must improve, and the VA outlined the steps it plans to take to address those concerns in its release.   

The agency has been on the GAO's "high-risk list" since 2015. The VA health system has been under intense scrutiny since a 2014 scandal revealed that veterans faced long waits for care at its facilities.  

Those programs the VA has started or is planning in the GAO's five risk areas include: 

  1. Cutting red tape: The VA is working to eliminate outdated or redundant policies and cut 235 expired directives and 85% of "outdated materials." 
  2. Trimming the bureaucratic fat: The agency said it cut 10% of its central office staff positions and consolidated operations in mental healthcare, geriatrics and primary care. These steps improve efficiency, according to the VA.
  3. Increasing accountability: The VA established an Office of Integrity that consolidates compliance, ethics and oversight programs, according to the announcement. It has also enhanced its internal auditing and governance capabilities.
  4. Modernizing technology: The department took significant steps to improve its electronic health record technology and enhance interoperability. 
  5. Clarifying priorities: The agency integrated its staffing processes into other systems through a central office and has improved resource management and allocation on the financial side. 

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"Under President Trump, we are serious about doing business differently to improve veterans' care and we are holding ourselves accountable to the nation's veterans and to American taxpayers who entrust them to our care," Acting Secretary Robert Wilkie said in the announcement.

The VA said that it has completed about 377 recommendations since 2009 from GAO to improve its healthcare system, and that at any time between 80 and 100 recommendations are actively being worked on. It said the next GAO report is expected in 2019. 

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Other steps the agency has taken of late include a planned overhaul of its Choice program, which was launched following the wait times scandal and allows veterans to seek care outside of the VA system. 

It also announced earlier this year an "aggressive" four-point plan for improving care at its lowest-performing hospitals. It named a national leader for improvement to oversee changes at these 15 facilities and has also emphasized increased accountability and clear priorities. 

Then-Secretary David Shulkin, M.D., said that leadership change was on the table if those hospitals didn't improve in a timely manner.