The Department of Veterans Affairs is under fire for using inappropriate scheduling practices that hid treatment delays at VA health clinics throughout the nation.
The Veterans Health Administration oversees the VA health network, placing the agency at the center of the growing controversy, which has given rise to official investigations and calls for VA Secretary Eric Shinseki’s removal from office.
Below are some key facts about the VHA to help put the agency’s work, it’s workload and its problems in perspective. The information comes from VA fact sheets, recent testimony from Shinseki and official reports.
Total enrollees: About 9.3 million of the nation’s 22 million military veterans are enrolled in the VA health-care system. Former troops qualify for VA health-care benefits if they have served in the active military and left under any condition other than dishonorable.
Facilities: The VHA is home to the largest integrated health-care network in the nation, with 150 VA hospitals and 820 outpatient clinics, as of 2013. The agency operates at least one medical center in each state, as well as in the District of Columbia and Puerto Rico. The facilities provide services ranging from primary care and surgery to mental-health treatment and rehabilitation.
Utilization: The health system handled about 84 million outpatient visits in 2012, representing a 23 percent increase compared to 2008. Shinseki said in testimony in March that a projected 6.7 million patients would likely use the network in 2015, representing a 17 percent increase compared to 2009.
In the VA’s 2010 national survey of veterans, 16 percent of respondents said they use the system as their primary source of health care, while 35 percent said they use it as a safety net and 32 percent indicated they have no plans to use it.
Patient-satisfaction: Despite its recent troubles, the VA health system has earned marks equal to or better than networks in the private sector in the 2013 American Customer Satisfaction Index.
The health system earned overall satisfaction indexes of 84 for inpatient care and 82 for outpatient services, while the U.S. hospital industry earned scores of 80 and 83 in those categories, respectively.
Jacob Gadd, the American Legion’s deputy director for health care, has said the scores probably reflect “pride among veterans that there’s a system for them that understands their unique needs.”
Gadd has also credited the VA with bolstering satisfaction levels through new initiatives such as the network’s “patient-aligned care teams,” which provide personalized care from groups of health professionals that fit patients’ individual needs.
A history of scheduling problems: In 2010, a top VA official issued a memo to the department’s medical centers listing 17 schemes that VA clinics were known to be using to cover-up treatment delays. The memo said the practices were inappropriate and would not be tolerated, but whistleblowers claim the actions continued for years.
Spending: In general, slightly more than 40 percent of the VA’s annual budgets went toward medical care between 2000 and 2013, although the percentage dipped last year to 38 percent of the VA’s $139 billion budget for benefits and services.
The VA spent $52.5 billion on hospital and medical care in 2013, more than double its expenditures in that category for 2000.
Staffing: VHA employees accounted for nearly 89 percent of the VA’s total 278,565 workers in 2008.
An audit two years ago determined the agency had not developed an effective method for determining whether staffing levels were appropriate at any given clinic. VA health official Thomas Lynch said during a hearing on Wednesday that the department is still not sure whether it needs to add or shift personnel to address the scheduling problems.
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