The U.S. Governmental Accountability Office (GAO) added the U.S. Department of Veterans Affairs to its biennial High-Risk List, a list of agencies and program areas that are “high risk due to their vulnerabilities to fraud, waste, abuse, and mismanagement, or are most in need of transformation.” The VA joins Medicare (added in 1990) and Medicaid (added in 2003) on the list, along with 29 other agencies.
GAO identified five areas of concern for the VA:
- Ambiguous policies and inconsistent processes
- Inadequate oversight and accountability
- Information technology challenges
- Inadequate training for VA staff
- Unclear resource needs and allocation priorities
GAO states that it has written over a dozen reports on these issues over the past few years. Each report included recommendations on how to address the weaknesses identified, but GAO notes that VA has failed to fully address more than 100 of these recommendations.
In 2014, Congress enacted the Veterans Access, Choice, and Accountability Act (Pub. L. No. 113-146, 128 Stat. 1754) which provides the VA with $15 billion in new funding. These funds are meant to address “serious and longstanding problems with veterans’ access to care.” GAO emphasizes that it is imperative that the VA address currently existing weaknesses so that it can utilize these funds effectively.
GAO specifically highlights the importance of coordination of care between VA and non-VA providers, particularly because, under the Veterans Access, Choice, and Accountability Act, veterans have the option to receive medical services from a non-VA provider when a VA facility cannot provide an appointment within 30 days. This may result in veterans receiving care from both VA and non-VA providers. GAO is concerned that a disconnect between these health care systems could lead to unfavorable health outcomes for veterans as well as duplication of services and waste.
GAO’s report concludes with a call for VA leaders to “fully commit themselves to developing long-term solutions that mitigate risks to the timeliness, cost-effectiveness, quality, and safety of the VA health care system.” It also calls for Congress to maintain its oversight of VA healthcare, noting that “sustained congressional attention to these issues will help ensure that VA continues to make progress in improving the delivery of health care services to veterans.