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  • Washington Highlights

    GAO Releases Report on VA Choice Program

    Kate Ogden, Physician Payment & Quality Specialist

    The Government Accountability Office (GAO) June 2 released a report on the Department of Veterans Affairs (VA) Choice Program, focusing on analysis of the program and recommendations for improvement. Overall, the GAO found that it is unclear whether the Choice Program improved the timeliness of veterans care, because VA data are incomplete and unreliable. The report specifically reviewed several access issues including: the VA’s appointment scheduling process, timeliness of appointments, information the Veterans Health Administration (VHA) uses to monitor veterans’ access to services, factors that have adversely affected veterans’ access to services, and steps that the VA has taken to address these issues in developing the VA’s future community care program.

    GAO found that numerous factors adversely affect veterans’ access to care through the current Choice Program, including the administrative burden caused by complexities in the referral and appointment scheduling processes, poor communication between VHA and VA Medical Centers (VAMCs), and inadequacies in the networks of community providers established by third-party administrators (TPAs). The report also focuses on interoperability issues between VAMCs and VA providers in their efforts to communicate and transfer medical records to community providers.

    As the VA moves to expand and make changes to the community care program, GAO made 10 recommendations, including:

    • Establish achievable wait time goal for the community care program that will allow greater monitoring by the VHA
    • Design an appointment scheduling process that adheres to this wait time goal and establishes further time frames for referral processing, appointment scheduling, and appointment occurrence
    • Implement mechanisms to allow VHA to monitor systematically the amount of time taken during the referral and appointment scheduling process
    • Establish a system that will help facilitate seamless efficient care coordination and information exchange among VAMCs, VHA clinicians, community providers, and Veterans.

    President Trump June 6 signed the VA MISSION Act, which replaces the existing Choice Program, including provisions related to GME and increasing provider recruitment [see Washington Highlights May 4, May 25]. Contracts to TPAs participating in the new community care network are expected to be awarded this fall.