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VA Health Care: Improving Veterans' Access Poses Financial and Mission-Related Challenges

HEHS-97-7 Published: Oct 25, 1996. Publicly Released: Oct 25, 1996.
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Highlights

Pursuant to a congressional request, GAO reviewed the Department of Veterans Affairs' (VA) efforts to establish health care access points to provide outpatient care for veterans who are geographically distant from VA hospitals.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Veterans Affairs The Secretary of Veterans Affairs should direct the Under Secretary for Health to establish a travel time or distance standard to be followed by VA hospitals as they plan for additional access points in their service areas.
Closed – Implemented
VA has addressed the recommendation by incorporating in its VHA Directive 96-049 (August 7, 1996) that Veterans Integrated Service Networks (VISNs) locate access points (clinics) "generally within 30 minutes travel time."
Department of Veterans Affairs The Secretary of Veterans Affairs should direct the Under Secretary for Health to require VA hospitals to establish their access points in a manner that focuses on the: (1) equalization of access for current users of the VA health care system on the basis of the designated time or distance standard; and (2) enrollment of any new users of the system in accordance with statutory priorities for VA care.
Closed – Implemented
VA has addressed Part 1 of the recommendation by incorporating in its VHA Directive 96-049 (August 7, 1996) that Veterans Integrated Service Networks (VISNs) locate access points (clinics) "generally within 30 minutes travel time." In response to Part 2, VA has restated its intentions to serve "existing patients" and new users "within existing resources and treatment priorities."
Department of Veterans Affairs The Secretary of Veterans Affairs should direct the Under Secretary for Health to provide Congress a report that presents the overall VA plan and time schedule for the systemwide establishment of access points to assist Congress in determining the affordability of the VA plan.
Closed – Implemented
VA does not agree that it is necessary to provide Congress with a report solely on VA's overall plans for systemwide establishment of access points. VA has completed an analysis that shows that 14 percent of veterans nationwide live further than 30 miles from a VA facility (VA's access standard). VA issued a Strategic Plan that calls for improved and more convenient access for patients through the opening of more community based outpatient clinics. This plan, however, provides no details regarding cost and affordability or the impact on veterans' access to care.

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Community health servicesEligibility criteriaHealth care cost controlHealth centersHealth services administrationMedicaidPatient care servicesPeople with disabilitiesStatutory lawVeterans benefitsVeterans hospitalsMedicareOutpatient care