VA Secretary issues blunt assessment of care for veterans

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The VA faces challenges as it attempts to improve access to care and bring its technology and facilities up to standards, said David Shulkin.

In a recent press briefing at the White House, Secretary of Veterans Affairs David Shulkin ran through his agency’s priorities for fixing its myriad challenges.

Shulkin did not mince words, noting that some of the current issues at the VA have developed over the course of decades and under multiple administrations. “This is the time for us to really address these chronic problems that have affected veterans and, in many ways, have harmed veterans and their families,” he said.

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Shulkin went on to highlight broad areas in which he sees the most risk for his agency:

  • Veterans’ access to care has been hampered by long wait times and clinics running near or at capacity, affecting their ability to deliver same-day services. While the Choice Program has improved veterans’ ability to get out-of-network services from community providers, Shulkin notes reimbursement issues have made the program complex and frustrating to navigate both for veterans and providers.
  • Even when veterans do get services, processing disability claims and appeals takes far too much time in many cases, according to the secretary. Roughly 90,000 disability claims reportedly take more than 125 days to process, a number the VA has targeted for a 50% reduction over the next two years.
  • Technology and other infrastructure at VA facilities tends to be out of date. Shulkin says the VA’s current physical assets would require $18 billion for remediation, and 20 facilities use outdated IT and inventory systems. The agency is working to replace systems and rationalize its physical plant, but budget and political realities have slowed both processes, according to the briefing.
  • Staff issues touched on by the secretary range from bureaucratic impediments to holding employees accountable for misconduct to attenuated onboarding processes that require more than 100 days to bring nurse or nurse practitioners into practice. Shulkin also reports that low salaries make recruitment and retention difficult.
  • Veteran suicides average 20 per day, which Shulkin terms “a national public health crisis,” and his “top clinical priority.” The agency will launch a new initiative, “Getting to Zero,” over the summer in a bid to reduce this number.