VA Wait List Increases as Department Faces $3B Budget Shortfall
Despite efforts to address wait times for veterans to receive care in the wake of a scandal over the issue last year, the number of veterans on wait lists has increased and the Department of Veterans Affairs faces a multi-billion-dollar budget shortfall, the New York Times reports (Oppel, New York Times, 6/20).
Former VA Secretary Eric Shinseki resigned last year following a scandal that exposed long wait times for veterans seeking health care and subsequent cover-up efforts (California Healthline, 7/30/14). Following the scandal, Congress passed a law to overhaul the agency and provide VA with about $16 billion over three years (California Healthline, 8/8/14).
The number of veterans waiting one month or longer to receive care has increased by 50% since the peak of last year's issues, according to department officials.
Since the public learned of the wait list scandal VA has broadly increased access to care, according to the Times. For example, VA has:
- Increased capacity by more than seven million patients;
- Handled about 2.7 million more appointments than in any year prior; and
- Authorized 900,000 more patients to seek care from an outside physician.
However, VA officials have said efforts to boost care access were not made with an awareness of how demand for care and physician workloads would continue to increase. VA Deputy Secretary Sloan Gibson said officials have been surprised at the number of new VA patients seeking treatment since it upped capacity.
For example, internal budget documents have revealed that physician workloads increased by:
- 21% in the region that includes Alabama, Georgia and South Carolina;
- 20% in the regions that include southern California and southern Nevada; and
- 18% in North Carolina and Virginia.
According to the Times, the data include multiple appointments by the same patients and reflect the fact that patients generally are scheduling a greater number of appointments than in the past.
Meanwhile, the number of individuals receiving treatment is increasing. Between 2012 and 2014, the number of VA patients receiving treatment increased by:
- 18% at a Nevada medical center;
- 16% at a Virginia medical center;
- 13% at a North Carolina medical center; and
- 13 % at an Oregon medical center.
Meanwhile, VA faces a budget shortfall of up to $3 billion, the Times reports.
Gibson said, "We have been pushing to accelerate access to care for veterans, but where we now find ourselves is that if we don't do something different we're going to be $2.7 billion short."
The cost increase has stemmed largely from a program that subsidizes care outside of VA for veterans who face delays or require treatment from outside of the system, according to the Times. Demand for prosthetic limbs and high-cost hepatitis C treatment also have driven cost increases. Costs for medical care have increased by almost 17%, and a large share of the increase is related to the new hepatitis C treatment.
In response, department officials plan to ask Congress to shift funding to high-need areas, Gibson said. The plan would include shifting funding the Choice Card program, which provides federally subsidized outside care to veterans who live far from care or face long wait times.
According to the Times, a request to shift funds from the program could create tension between VA and Republican lawmakers. Gibson already has drawn criticism from the GOP for what it considers an inadequate effort to get the program started, the Times reports (New York Times, 6/20).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.