VA's push to reduce claims backlog could backfire

Claims processors at the U.S. Department of Veterans Affairs are worried that the announced push to eliminate the looming backlog of disability claims by 2015 emphasizes quantity over quality, and could lead to mistakes in the process, according to a recently published investigative report by News21.

In 2011, the VA's backlog grew by 155 percent, according to News21, due to a combination of factors, including performance standards, job security and bonus money. Claims processors, including Renee Cotter, told News21 that they often would put more difficult claims on the back burner in favor of easier claims to inflate their productivity. To that end, it worked, as roughly two-thirds of the VA's processors that year earned bonuses totaling $5.5 million.

"I'd try to work my really easy stuff so I could get my numbers up," Cotter said.

But last year, a board of judges determined roughly 75 percent of appealed claims to be "wrong" or based on incomplete information, according to the report. The VA also altered performance criteria for processors between 2010 and 2012 to encourage speed over accuracy, according to News21.

What's more, the VA's plan to improve accuracy by scanning existing paper claims into a new electronic system--the Veterans Benefits Management System (VBMS)--has been expensive and problem-ridden, according to News21. In June, the VA announced that a joint web portal with the Department of Defense--eBenefits--had been installed at all 56 regional offices ahead of schedule; the tool integrates with the internal VBMS, enabling disability compensation claims to be processed more quickly online.

Earlier this month, President Obama touted progress in the VA's efforts to reduce the backlog, saying disability claims had been reduced by 20 percent since March. The backlog, which stood at 611,000 claims in March, was down to 496,000 claims as of Aug. 9.

"We're turning the tide," Obama said. "And we're not going to let up until we eliminate the backlog once and for all." He added that the VA will continue to press forward using "paperless systems" to ensure that claims "are processed right--the first time, on time."

To learn more:
- read the News21 report

Suggested Articles

Telehealth giant Teladoc completed its massive $18.5 billion acquisition of Livongo, the company announced Friday.

Nurx says it's the largest female-focused telehealth player, and it's brought on former Walmart and 23andMe executives to help expand its services.

Welcome to this week's Chutes & Ladders, our roundup of hirings, firings and retirings throughout the industry.