Report: VA Needs ‘Systemwide Reworking’ To Fix Health Care Issues

The Veterans Health Administration has significant flaws, including unsustainable costs and leadership issues, according to a broad review of the Department of Veterans Affairs health care system, the Wall Street Journal reports. According to the review, VHA will require a "systemwide reworking" to adequately address the issues.

Background

The report is made up of more than a dozen assessments from outside groups that were required under the Veterans Access, Choice and Accountability Act. The assessments come from groups like Mitre, RAND and McKinsey.

An emergency funding measure was passed last year following a wait-time scandal at several VA health care facilities (Kesling, Wall Street Journal, 9/18). The law included about $12 billion in emergency funding and $5 billion from spending cuts within the VA system. It allotted $10 billion to allow veterans facing long wait times or distances to seek private care outside the VA health system and $5 billion for VA to hire additional providers (California Healthline, 8/8/14).

The law also created the Commission on Care, which will use the new assessments to present a reform plan to VA and Congress early next year.

Report Findings

Overall, the assessments found that VHA is plagued with lingering problems, including:

• A potentially unsustainable capital budget;
• Bureaucracy issues; and
• Problems with leadership.

While the assessments noted that VA outperformed non-VA care systems in several measures, they also found:

• Inconsistencies in care across the system;
• Mismanagement; and
• Vacancies in leadership positions.

According to the report, the vacancies exist despite 160% growth at VA's central office over the past five years. In addition, the report noted that more than 50% of individuals in leadership positions at VA are eligible to retire and could leave at any time, which could exacerbate the problem.

The review concluded, "The independent assessment highlighted systemic, critical problems" at VHA, adding, "Solving these problems will demand far-reaching and complex changes that, when taken together, amount to no less than a systemwide reworking of VHA."

Reaction

VA said it "is undergoing a radical transformation," adding, "VA will work with Congress, veterans service organizations, veterans and other stakeholders on the recommendations outlined in the Independent Assessment Final Report." Further, VA said it "will especially work closely with Congress on those final report recommendations that specify specific congressional action needed to implement."

Senate Committee on Veterans' Affairs Chair Johnny Isakson (R-Ga.), said, "The report bears out collectively what I have seen individually, what I have seen in my role as chairman over the past nine months." He added, "There is a huge focus on some glaring deficiencies that need to be addressed" (Wall Street Journal, 9/18).