Wednesday, October 16, 2019

VA Sees Improvements in Patient Satisfaction, Care Access

Eighty-two percent of veterans expressed high patient satisfaction with the agency's healthcare offerings, citing improve care access.
October 14, 2019 - Patient satisfaction and care access are on the rise at the Department of Veterans Affairs (VA), an agency previously under fire for its shortcomings in patient care, according to a new survey from the Veterans of Foreign Wars (VFW).
After years of industry and government scrutiny, the VA has heard some positive feedback from the veterans who utilize its healthcare services. A patient satisfaction survey related to VA care quality, community care access, and the VA MISSION Act showed that the agency might be on the right track to improving veteran healthcare.
“The VFW survey highlights the great work that we are seeing at VA across the nation,” VA Secretary Robert Wilkie said in a statement. “The 2019 Our Care survey results highlight VA’s continued commitment to improving Veteran care and how Veterans access the benefits they have earned, including improvements to facility availability, the streamlining of community care programs under MISSION Act and overall technological modernization.”
The VA has seen years of industry scrutiny following the infamous wait list scandal in 2014. Since then, the agency has worked to revamp its offerings by expanding veteran access to care through the Veterans Choice Program and more recently the VA MISSION Act, as well as by improving its health technology offerings.
But those efforts have been fraught, with government watch dog agencies reporting hiccups with VA improvement projects. Separate news reports have shed the VA in a negative light as limited mental healthcare access and poor facility conditions have left a poor taste in some veterans’ mouths.
But those issues may be working themselves out, as 82 percent of veterans report being at least somewhat satisfied with the healthcare they have received through the agency, the VFW report showed.
Seventy-four percent of the 6,900 respondents said they have seen improvements in their preferred VA facilities within the past year, a ten-percentage point boost since last year’s observations. Ninety-one percent of veterans said they would recommend receiving healthcare through the VA, save for one outlier state. In Alabama, only 74 percent of veterans recommended VA healthcare.
Nationally, however, the number of veterans expressing dissatisfaction with their healthcare is relatively low. Only 7 percent of veterans said they were not satisfied with their VA healthcare and only 11 percent said they were neither satisfied nor dissatisfied. Fewer than one in ten veterans would not recommend VA healthcare.
There is still room for growth, the survey authors acknowledged. After all, nearly one-quarter of respondents said they did not see improvements at their VA facilities or that their facilities needed to make some improvements.
These findings come as the VA continues to recover from the wait list scandal at an Arizona facility back in 2014. Reports showed that VA facility leaders instructed workers to falsify wait lists to give the appearance that veterans were receiving appointments within the 30-day threshold spelled out by the agency. The crisis culminated in then-VA Secretary Eric Shinseki’s resignation.
But those issues may be turning around, as 84 percent of veteran respondents report that they have received their care in a timely manner. Fifty-four percent of respondents said they received an appointment within 14 days for most of their healthcare needs and 80 percent said they obtained an appointment within the 30-day timeframe outlined by the VA.
Of the 20 percent who waited longer than 30 days for an appointment, 11 percent waited between 31 and 60 days, 5 percent waited between 61 and 90 days, and 4 percent waited longer than 90 days to schedule an appointment.
Improved patient access to care is near certainly the result of new executive leadership at the VA, the VFW authors noted, as well as perhaps the result of expanded community care options. Nearly 2,800 veterans responding to the satisfaction survey were offered access to community care options and 55 percent said they utilized community care.
The community care options allow veterans to access healthcare from civilian providers when that treatment is otherwise unattainable through the VA. Veterans facing extraordinary travel distances, long wait times, or treatments not covered by the VA may receive a referral to community care to be coordinated by the VA.
This care option was further expanded through the VA MISSION Act, rolled out earlier this year.
Prior to the MISSION Act, 45 percent of veteran respondents said they’d accessed community care, and more than half said they were at least satisfied with their care.
Veterans also managed to receive community healthcare in a timely manner, according to the survey. Sixty percent of veterans using community care received an appointment within 14 days, while 84 percent received an appointment within 30 days.
While care access through community healthcare options has been high, the VFW did find that billing complications abound. Twenty-one percent of veterans receiving community care got a bill from both the community provider and the VA. Thirty-eight percent of veterans said the VA did not pay the medical bill. In fact, one in ten respondents said VA could improve its community care billing strategies.
Fourteen percent said the referral and follow-up process for community care access needs changes, while 11 percent wanted better communications with their community care providers. Eighteen percent of respondents said they would like access to more community care providers.
Data was more limited for veterans accessing community care options after the MISSION Act went into effect on June 6, 2019. Forty-five percent of respondents said they opted for community care over VA care after that point, with some saying there were referral and follow-up problems.
One-quarter of veterans accessing the expanded community care offerings experienced wait time issues.
Nonetheless, these findings represent a significant step forward for the VA, which has been under the microscope of lawmakers and healthcare and veterans advocates for years. These improvements underscore a need for continued work, the VFW authors said. Specifically, the VFW authors urged veterans to outline their specific benefit needs to the VA.
“The innovations to VA care over the past year may have expanded non-VA care delivery options, but veterans have responded by only enrolling in VA for more care – with many choosing to receive that care through VA,” the report authors concluded. “Now more than ever, it is clear to the VFW that the binary choice of VA care or privatized care remains a false choice, as VA must continue to have the ability to deliver direct care and contract for community care options guaranteed by VA.”

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