OIG: Delays, scheduling violations plague VA's private-care fix

More than a year after the Department of Veterans Affairs (VA) came under fire for care delays, a heavily-touted solution that would allow veterans to seek private healthcare suffers from similar problems, according to a new report from the VA Office of Inspector General.

VA inspectors uncovered issues ranging from care delays to cost overruns to improper scheduling practices within the Patient-Centered Community Care (PC3) program, according to the report. Inspectors based their findings on research at nine VA facilities, including the Phoenix VA, which was ground zero for the scandal in 2014 when it was discovered to have a "secret" waitlist concealing care delays.

Every VA inspector interviewed said his or her facility had either significantly scaled back the PC3 program or dropped it entirely due to these problems. VA contractors regularly "blind-scheduled" patients, or set up appointments without first confirming patient availability. Moreover, inspectors reported, contractors have not kept patient appointments within timeliness requirements, nor have VA staff given contractors necessary authorization in a timely manner.

Research also found a shortage of private physicians contracted through Health Net Federal Services and TriWest Healthcare Corporation, which handle private-care booking for the VA. Inspectors found TriWest took 21 days to create an appointment on average, even though its contract requires it to create them within five business days. Nearly all appointment requests were unfilled for certain specialties, according to the report, and contractors have failed to provide medical documentation and inaccurately reported unfilled appointments to the VA.

TriWest said in a statement to the press that many of these problems were largely restricted to the early stages of the program and have since improved, according to Arizona Central. "We are proud of the fact that the PC3 program was used by VA here in Phoenix to assist them in eliminating the initial backlog of more than 14,700 veterans between April and August 2014," the company said. "Following that time, we evaluated together the opportunity for refinement and have implemented most of those changes, to include a brand new system through which we move patient information to speed service and enhance effectiveness."

The report comes less than a month after VA officials admitted to problems with payments to medical providers outside of the agency's system in testimony to the House Veterans Affairs subcommittee on health, FierceGovernment previously reported.

To learn more:
- download the report
- here's the article

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