Some newly enrolled veterans seeking a primary care appointment at the Department of Veterans Affairs (VA) wait more than 90 days before they see a provider, and the agency’s way of calculating wait times understates them, according to a new report by a government watchdog office.
“This most recent work on veterans’ access to primary care expands further the litany of VA health care deficiencies and weaknesses that we have identified over the years,” Debra Draper, director of the Government Accountability Office’s (GAO) health-care team, said in testimony to the House Committee on Veterans’ Affairs. “As of April 1, 2016, there were about 90 GAO recommendations regarding veterans’ health care awaiting action by VHA … (including) more than a dozen recommendations to address weaknesses in the provision and oversight of veterans’ access to timely primary and specialty care, including mental health care.
“Until VHA can make meaningful progress in addressing these and other recommendations,” she added, “the quality and safety of health care for our nation’s veterans is at risk.”
The new GAO report looked at wait times for newly enrolled veterans seeking primary care appointments at six VA medical centers around the country. Among a random sample of 180 of those veterans, 60 who requested care had not been seen at all by primary care providers, in some cases because the VA never contacted them or because they were left off an eligibility list in error. For the other 120 who requested care and were seen, the average time between their initial requests that the VA contact them for appointments and the dates they were seen ranged from 22 to 71 days.
While slightly more than half were seen by providers in less than 30 days, the veterans’ experiences varied widely, even within the same medical center, with 12 veterans waiting more than 90 days, the report says.
The most recent national data from the VA shows that, on average, the wait time for primary care appointments as of April 1, 2016, was seven days – down from 7.94 days a year ago.
In Connecticut, the West Haven VA shows a wait time for primary care of just 1.72 days – relatively low nationally. Overall, more than 97 percent of veterans seeking health care in West Haven get appointments scheduled within 30 days, the data show.
Other VAs have much longer waits. The average wait for a primary care appointment in Fayetteville, NC, is 52.76 days; in White City, Oregon, 51.14 days; and in Dover, Tenn., 48 days.
Nationally, wait times for specialty care average 10 days, and for mental health care, four days. At the West Haven VA, wait times are 4.86 days for specialty care and 2.25 days for mental health care, the most recent data show.
The GAO report found that two factors generally impacted veterans’ wait times: Appointments were not always available when veterans wanted to be seen, and “weaknesses in VA medical scheduling practices” led to some veterans not being contacted on a timely basis.
“Officials at each of the six medical centers in our review told us that they have difficulty keeping up with the demand for primary care appointments for new patients because of shortages in the number of providers, or lack of space due to rapid growth in the demand for these services,” the GAO said.
Also, the report says, the VA does not properly record the time that veterans wait to be seen, starting from the veterans’ “preferred dates” for appointments, instead of the dates that veterans initially contact the VA to schedule appointments. These “scheduling errors, such as incorrectly revising preferred dates when rescheduling appointments, understated the amount of time veterans waited to see providers,” the GAO said.
For example, one veteran mentioned in the report applied for VA health care benefits in December 2014, which included a request to be contacted for an initial appointment. The VA medical center contacted the veteran to schedule a primary care appointment 43 days later. When making the appointment, the medical center recorded the veteran’s preferred date as March 1, 2015, and the veteran saw a provider on March 3, 2015. Although the medical center’s data showed the veteran waited two days to see a provider, the total amount of time that elapsed from the veteran’s request until the veteran was seen was actually 76 days.
The GAO recommended that the VA monitor the full amount of time that veterans wait to see a primary care provider and improve contact with veterans seeking appointments – recommendations that the VA accepted.