VA scandal: Audit reveals 57,000 vets awaiting medical appointments

Another 63,000 veterans enrolled in the system but never were seen for care
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An internal Department of Veterans Affairs (VA) audit reveals that more than 57,000 vets are still waiting for care 90 days after requesting an appointment.

The VA released the findings of its nationwide access audit today in the wake of allegations of secret waitlists to cover up the fact that thousands of veterans at a Phoenix medical center waited months for care.

"This data shows the extent of the systemic problems we face, problems that demand immediate actions," Acting Secretary of Veterans Affairs Sloan Gibson said in an announcement. "As of today, VA has contacted 50,000 Veterans across the country to get them off of wait lists and into clinics. Veterans deserve to have full faith in their VA, and they will keep hearing from us until all our Veterans receive the care they've earned."

Nationwide, an estimated 57,436 veterans are waiting to be scheduled for care, and another 63,869 have enrolled in the VA healthcare system over the past 10 years and have not been seen for an appointment, according to a fact sheet about the audit findings.The VA is "moving aggressively" to contact these veterans.

The 59-page report determined that the VA's scheduling process was overly complicated, causing confusion among scheduling clerks and frontline staff. In addition, the 14-day policy for new appointments wasn't an attainable goal due to the growing demand for services.

Thirteen percent of scheduling staff interviewed as part of the audit reported they received instruction from their supervisors to enter in a "desired date" that was different from the date the veteran requested. The audit found that the practice occurred in 76 percent of all VA facilities.

"Findings indicate that in some cases, pressures were placed on schedulers to utilize inappropriate practices in order to make waiting times (based on desired date, and the waiting lists), appear more favorable," the report said. "Such practices are sufficiently pervasive to require VA re-examine its entire performance  management system and, in particular, whether current measures and targets for  access are realistic or sufficient."

The biggest challenge to timely access to care was due to a lack of provider slots, according to staff interviews. The limitations of the 14-day goal, limited clerical staff, inadequate training of schedulers and the inflexibility of the scheduling software goals also contributed to the problems, the report found.

The report didn't indicate whether any veterans died as a result of the treatment delays.

As a result of the findings, Gibson announced the following immediate actions:

  • Develop a new patient satisfaction measurement program to include data of veterans attempting to access the VA healthcare system for the first time. This field will ensure that the VA gathers data from the veteran's perspective.

  • Hold senior leaders accountable for specific incidents identified as part of the audit.

  • Set up a hiring freeze at the central office in DC and the 21 regional offices. except for critical positions approved by Gibson on a case-by-case basis.

  • Remove the 14-day scheduling goal from employee performance contracts.

  • Increase transparency by posting regular updates to the access data twice a month.

  • Initiate an independent, external audit of scheduling practices throughout the VA system.

  • Send additional frontline staff to the Phoenix site to address the scheduling and access concerns.

  • Use high-performing facilities to help those sites that need improvement.

  • Apply immediate access reforms to all facilities that face similar problems as the Phoenix facility.

  • Hire additional clinical and patient support staff.

  • Modify local contract operations to offer more community-based care to veterans.

  • Remove senior leaders at certain facilities as appropriate.

  • Suspend performance awards for fiscal year 2014.

To learn more:
- here's the announcement
- read the report (.pdf)
- check out the fact sheet (.pdf)

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