VA Management Challenges: Actions Needed to Improve Management and Oversight of VA Operations

What GAO Found

The Department of Veterans Affairs (VA) is responsible for providing benefits, including health care to over 9 million enrolled veterans, as well as various types of financial assistance and burial services. However, VA has faced longstanding challenges managing and overseeing its operations. As of January 9, 2019, VA had 223 open recommendations. GAO considers 30 of these recommendations to be the highest priority for VA to implement, as of March 2019. These recommendations are in the areas of veterans' access to timely health care, veterans' use of community-based health care, quality of care and patient safety, information technology, and national policy reform, among others.

Fully implementing these 30 priority recommendations could significantly improve VA's management and oversight of its operations. In addition, VA needs to make systemic changes to its management and oversight in order to improve the health care provided to our nation's veterans. GAO continues to be concerned about VA's ability to ensure that its resources are being used cost-effectively and efficiently to improve veterans' access to high quality and safe health care. 

Why GAO Did This Study

For several decades, GAO has issued hundreds of reports containing recommendations for VA to improve its management and oversight of the services it provides to veterans. The number of open recommendations to VA is one reason that GAO added VA health care to the GAO High-Risk List in 2015. In March 2019, GAO also added VA's acquisition management to the High-Risk List. Further, several other government-wide high-risk areas—including strategic human capital management, improving and modernizing federal disability programs, and ensuring cybersecurity of the nation—have direct implications for VA and its operations.

The Committee report to the Consolidated Military Construction, Veterans Affairs, and Related Agencies Appropriations Act of 2018 required GAO to submit a list of the most significant VA management issues on which GAO has made recommendations. This report summarizes priority open recommendations GAO has made to address VA management and oversight challenges and improve operations, whether VA agreed with the recommendations, and what actions VA still needs to take to implement these recommendations.

To address this objective, GAO reviewed its products with open recommendations to identify recommendations that relate to the most significant VA management and oversight challenges. GAO used several criteria to identify these recommendations, including the potential to realize large dollar savings, aid in congressional decision-making, and eliminate management, fraud, and abuse. These are the same criteria that GAO used to identify the recommendations as high priority.