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The Mission Act Reforms Could Lead to More Long Wait Times for Care

Friday, February 7, 2020

In 2018, it was reported that Department of Veterans Affairs patients seeking private sector healthcare saw a nearly two-month delay for medical appointments. Now, according to a new report by the VA Office of Inspector General, the reforms to the Mission Act could worsen these delays.

The VA Mission Act aims to greatly improve veteran access to VA healthcare. The legislation’s formal name is the VA Maintaining Systems and Strengthening Integrated Outside Networks Act. Recent reforms were focused on giving veterans more healthcare options by establishing new criteria that determine a veteran’s eligibility to receive community care. The criteria includes veterans needing a specific service not available at a VA medical facility, veterans living in a U.S. state or territory without a full-service VA facility, and several other circumstances in which veterans can seek care outside of the VA.

The new report by the inspector general is based on conclusions on a region of VA hospitals that includes 1.6 million veterans across Georgia, Florida, Puerto Rico, and the Caribbean. VA officials in this region fielded more than 200,000 requests in 2018 for community care at clinics outside the VA network. On average, these veterans faced a 56-day wait before receiving care.

Though the Mission Act aims to expand the scope of private sector care attainable by veterans, these findings suggest that the problem could be augmented under the reforms. The inspector general says that under the Mission Act’s reforms, the number of veterans seeking community care will increase to 3.7 million, which would drive wait times up enormously.

Regarding the cause of the high wait times, the VA found that it was largely driven by a lack of adequate administrative staffing at VA medical centers. In 2018, 39% of patients were sent for treatment outside of the VA because the government facilities could not meet patients’ needs in a timely manner. Now under the act, this burden is likely to be transferred to private hospitals.

Senator Jerry Moran, chairman of the Senate Committee on Veterans’ Affairs, said “While the VA is in the process of hiring well-trained staff to streamline the scheduling process, they will also need the right technology and data solutions to make community care appointments more seamless for veterans.”

The region that the VA inspector general’s report is based on has now implemented an industry-standard referral; and authorization management system that aims to expedite community care consultations and referrals. Perhaps this will alleviate some of the administrative difficulties caused by the influx in referrals to private hospitals. 

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