Skip to main content

Closer Look at a New High Risk Area—Managing Risks and Improving VA Health Care

Posted on February 19, 2015

Last week, we issued our 2015 update to our High Risk List. Today, we take a closer look at 1 of the 2 new areas: Managing Risks and Improving VA Health Care.

In the spring and summer of 2014, delays in care at VA medical facilities drew media attention and spurred more than 20 congressional hearings. We have made numerous recommendations to VA to improve the timeliness, cost-effectiveness, quality, and safety of the care it provides to veterans. However, VA has yet to fully implement more than 100 of our recommendations.

Our concerns about VA health care fall into 5 broad areas:

  1. Ambiguous policies and inconsistent processes. We’ve found that unclear policies led VA staff to inaccurately record the required dates for appointments, and inconsistently track waiting times for new patients.
  2. Inadequate oversight and accountability. VA doesn’t routinely assess how well its facilities implement certain policies, and often relies on facilities’ self-reported data, which are often inaccurate or incomplete.
  3. IT challenges. We’ve repeatedly reported on VA’s outdated, inefficient IT systems. For example, for more than a decade we’ve reported on how VA and DOD electronic health record systems don’t work with each other efficiently.
  4. Inadequate training for VA staff. VA’s training requirements can be both burdensome to complete and insufficient. For example, we found that training for staff responsible for cleaning and reprocessing reusable medical equipment was lacking, potentially exposing patients to dirty equipment and infection.
  5. Unclear resource needs and allocation priorities. VA lacks the data it needs to make important management decisions about where to allocate its resources. For example, VA cannot readily access the data it needs to determine whether its existing nurse workforce matches its clinical needs.

Watch this video for more information about why veterans’ health care was added to our High Risk List.

2015 High Risk Overview From the Comptroller General


Comptroller General Gene Dodaro introduces GAO’s 2015 High Risk list, and GAO directors explain the two new areas added to the list.

Comments on GAO’s WatchBlog? Contact

GAO Contacts

Debra A. Draper
Debra A. Draper

Related Products

About Watchblog

GAO's mission is to provide Congress with fact-based, nonpartisan information that can help improve federal government performance and ensure accountability for the benefit of the American people. GAO launched its WatchBlog in January, 2014, as part of its continuing effort to reach its audiences—Congress and the American people—where they are currently looking for information.

The blog format allows GAO to provide a little more context about its work than it can offer on its other social media platforms. Posts will tie GAO work to current events and the news; show how GAO’s work is affecting agencies or legislation; highlight reports, testimonies, and issue areas where GAO does work; and provide information about GAO itself, among other things.

Please send any feedback on GAO's WatchBlog to