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Veterans Affairs: Addressing Longstanding Management Challenges Requires Sustained Leadership

GAO-23-106636 Published: Feb 28, 2023. Publicly Released: Feb 28, 2023.
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Fast Facts

The nation's veterans and their families rely on Veterans Affairs for health care and disability benefits. We testified on our body of work covering VA's longstanding challenges in:

  • Ensuring that veterans get the health care they need
  • Managing supply chains and VA's acquisition workforce to ensure VA medical centers get needed medical supplies
  • Administering disability benefits to ensure that veterans get appropriate, timely compensation
  • Securing veterans' electronic health records and other sensitive data

Since 2000, we've made over 1,500 recommendations to help VA improve its vital services for veterans. Of those, 220 still need action.

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What GAO Found

The Department of Veterans Affairs (VA) has faced growing demand for its health care services. In fiscal year 2023, VA received a total budget of $303.2 billion. This includes the largest discretionary budget in its history, $134.7 billion, about $22.5 billion higher than in fiscal year 2022.

Over the past several years, GAO added VA health care; VA acquisition management; federal disability programs, including VA disability compensation; and government-wide cybersecurity to GAO's High Risk List. This list identifies areas that are most vulnerable to fraud, waste, abuse, or mismanagement, or are in need of transformation. VA has made marked progress recently in addressing these high-risk issues, such as by identifying root causes of the deficiencies and establishing action plans to address them. However, these are only the initial steps of the long-term commitment required to achieve transformational change.

VA health care. The total number of veterans enrolled in VA's health care system increased from 7.9 million to about 9.2 million from fiscal year 2006 through fiscal year 2022. GAO has identified challenges related to VA's management and oversight of its health care system, including

  • Ensuring veterans' health care appointments are scheduled in a timely manner.
  • Having complete information to determine if it has an adequate number of health care providers to meet veterans' needs.
  • Effectively identifying and meeting the demand for mental health and other behavioral health services among veterans.
  • Ensuring timely implementation while addressing data quality issues as it works to modernize its electronic health record system.

VA acquisition management. VA obligated about $56 billion for goods and services in fiscal year 2022. GAO has identified challenges in VA's acquisition programs such as VA's development of adequate strategies and policies, as well as its management of its supply chain and its acquisition workforce.

VA disability programs. As one of the largest disability compensation programs in the nation, VA provided over $112 billion in compensation to approximately 5.6 million veterans and their families in fiscal year 2021. GAO has identified challenges within these compensation programs, including overseeing the medical exams needed to make decisions about disability claims.

VA cybersecurity and privacy. Vulnerabilities arising from VA's increased dependence on information technology can result in the compromise of sensitive personal information, such as inappropriate use or disclosure. The VA Office of Inspector General identified significant deficiencies in VA's efforts to implement an agency-wide information security program that met the requirements of the Federal Information Security Modernization Act of 2014.

Addressing each of these longstanding challenges requires sustained leadership and would help ensure veterans receive the care and benefits they deserve.

Why GAO Did This Study

VA is responsible for providing benefits to veterans and their families. This includes disability compensation and health care. VA operates one of the largest health care delivery systems in the nation.

Over the last decade, GAO has identified significant challenges in VA's leadership and operations, including health care, acquisitions, disability programs, and cybersecurity. These longstanding challenges can affect VA's current efforts to provide timely access to high quality care and benefits. They can also impede its capacity to take on new responsibilities for the recent expansion of benefits for those exposed to toxins.

This testimony summarizes the longstanding management challenges at VA that GAO has identified, including those about (1) health care, (2) acquisition management, (3) disability benefits, and (4) privacy and cybersecurity. This testimony also highlights the recommendations GAO has made to VA to improve these issues. It is based on findings from prior reports from 2012 to 2023.

Since 2000, GAO has made 1,519 recommendations to VA. VA has implemented many of those. As of February 2023, 220 remain to be addressed; 19 of these GAO considers high priority.

For more information, contact Sharon M. Silas at (202) 512-7114 or for VA health care issues; Shelby S. Oakley at (202) 512-4841 or for VA acquisition management issues; Elizabeth A. Curda at (202) 512-7215 or for disability benefit issues; Jennifer Franks at (404) 679-1831 or for privacy and cybersecurity issues; and Thomas Costa at (202) 512-7215 or for VA sexual harassment and racial discrimination issues.

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