Attempt to Help Underserved VA Populations Find Health Care Yields Mixed Results

THE BIG STORY

Underserved Veteran Populations Still Struggle to Find VA Health Care, Report Says

The GAO report offers pointed criticism as well-meaning program seeks solid footing

It’s still tough for veterans living in certain areas to get timely health care.

Whether they’re living in large and undeveloped states such as Montana or North Dakota, or in highly developed areas where the high cost of housing pushes veterans from hospitals, the end result is the same according to the Government Accountability Office: veterans waiting on service, unable to get treatment quickly or effectively.

Connecting veterans who can’t easily access Department of Veterans Affairs Medical Clinics (VAMCs) with health care has been a high priority for decades. For much of that time, one of the key limiting factors was the cost of infrastructure. It’s expensive to build and staff a clinic, and in scarcely-populated places. This led to different experiments, including launching The Veterans Choice Act in 2014 that allowed veterans to seek treatment from private doctors. That program never really got off the ground.

In 2019, with video conferencing becoming more widespread (though still not as ubiquitous as it became during the pandemic), the VA began the “medically underserved facilities initiative.” This involved establishing a mechanism for evaluating VAMCs, assigning each a rating using a point system. The 10 highest scores — 5 for primary care, 5 for mental health — were designated as “underserved” and required to design and implement plans to address that, with some analytics assistance.

After an investigation, the GAO found that results have been mixed: some felt the program helped, others that it harmed the VAMC in question’s ability to provide care; others still, that it offered no tangible benefit, but neither did it impede care.

For 2023, the VA facilities selected for primary care were Texas Valley Coastal Bend, TX (the most underserved in the nation, though this was its first time on the list), Fayetteville, NC (the second most underserved; this was its 4th designation since 2019), Jackson, MS (third most underserved, its second time so designated), Clarksburg, WV (fourth most underserved, first time on the list), and Hampton, VA (the fifth most underserved facility and the only primary care facility to have received the designation all 5 years the program has been active).

Those VA facilities selected as being underserved when it came to mental health were Sioux Falls, SD (most underserved, third time to receive the designation since 2019), Manchester, NH (second most underserved, first time on the list), Montana (third most underserved, and the only system on the list all five years), Fargo, ND (fourth most underserved and the third time on the list), and Fayetteville, NC (fifth most underserved, fourth time on the list, and the only facility to appear under primary and mental health lists).

The GAO remarked in its report on the mixed feedback about the program’s success from participating VAMCs; it also pointed out that there was often not a significant difference between the 10 most underserved clinics and other clinics that were just a point or two off. Furthermore, the GAO investigators concluded that a major hindering factor with the program was a lack of clear and consistent indicators for success.

Every effort to improve health care and accessibility for veterans is worthwhile. The program doesn’t cost much (a little over $1 million per year) and is generating useful data about ways to improve a deeply entrenched obstacle to healthy veterans. So far, though, it has borne little fruit.

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Veteran wanders around the Px avoiding work reminiscing about when they were in service, wandering around the Px avoiding work. Via Duffelblog.