AMVETS in Action

Fix the VA

Fix the VA

Recog­ni­tion of any prob­lems within the VA health­care sys­tem should not be taken as a need or desire to com­pletely dis­man­tle or replace our exist­ing vet­er­ans’ health­care sys­tem, but only to improve it. The cul­tural and health­care needs of our vet­er­ans are unique and the VA alone is uniquely qual­i­fied to meet those impor­tant needs. The basic framework for suc­cess is already in place and imme­di­ate results are achiev­able with prompt, effec­tive and culture-changing best prac­tices; let’s not throw out one of the pre­mier health­care sys­tems in the world in our haste to fix these cur­rent prob­lems or achieve polit­i­cal goals.

It is our respon­si­bil­ity to vig­or­ously defend a sys­tem that has set itself above all other major health-care sys­tems in this coun­try. In spite of all of the crit­i­cism that the VA health-care sys­tem receives, it con­tin­ues to out­per­form every other healthcare sys­tem in Amer­ica, both in qual­ity of care and patient sat­is­fac­tion. The one main focus mov­ing for­ward is the health and well-being of our vet­er­ans. AMVETS offers these rec­om­men­da­tions to help save and improve our VA health­care sys­tem, not elim­i­nate it:

Specific Recommendations:

  1. Ensure both advanced appropriations and discretionary funding for VA, as recommended in the IB, keeps pace with medical care inflation and healthcare demand so that all veterans healthcare needs can be adequately met;
  2. Maximize the use of non-physician medical personnel to mitigate physician shortages and reduce patient wait times especially while utilization of the VA system continues to rise;
  3. Ensure VA makes more realistic third-party medical care collection estimates so that Congress doesn’t under-appropriate funds based on false expectations which in turn negatively impact veteran care
    1. VA needs to redouble its efforts to increase its medical care collections efforts (the cumulative effects of overestimating and under-collecting only degrade the care available to our veterans)
    2. Establish both first- and third-party copayment accuracy performance measures which would help minimize wasted collection efforts and veteran dissatisfaction;
  4. Incorporate civilian healthcare management best practices to attract the best and the brightest healthcare managers in the industry
    1. Include a pathway to VA hospital/clinic management for civilians as part of their succession plan requirements
    2. Adopt proven recruitment, hiring and retention policies to ensure the timely delivery of high quality healthcare to our veterans. (VA’s current cumbersome and overly-lengthy hiring process reduces its ability to deliver critical services. Adopting a more expedient hiring/approval process could include some form of provisional employment;
  5. Immediately increase doctor/patient (d/p) ratio to realistic and productive levels; this one change would drastically improve access to needed healthcare by cutting wait times for veterans needing treatment and/or referrals
    1. Current VA (d/p) ratio is only 1:1200, the (d/p) ratio for non-VA physicians is close to 1:4200;
  6. Improve the patient management system to provide veterans more appointment setting options and reduce staffing errors and requirements
    1. Utilize a private sector best practice hybrid system whereby a portion of the day consists of scheduled appointments and the other portion for walk in or same-day appointments
    2. Eliminate the need for non-specialty appointments to allow veterans quicker access to their primary care providers;
    3. Expand primary care appointment hours to include evening/after hours and Saturdays to help reduce wait times and improve access to needed healthcare
  7. Bring in outside advisory/consulting expertise to reassess VA’s organizational structure and improve its healthcare operations
    1. Adopt private sector best practices for system efficiencies, maximizing human and financial resources, and minimizing waste and redundancies;
    2. Incorporate private sector best practices to rebalance the administrative staff to patient-focused clinical staff ratios
    3. Reduce administrative staff by implementing monitoring and patient advocacy positions at VA Medical Centers to be resourced by trained volunteers from Veteran and Military Service Organizations
  8. Collaborate with HHS (Health & Human Services) to utilize/share the benefits of the Uniform Data System (UDS)
    1. The UDS is a core set of information appropriate for reviewing and evaluating the operation and performance of individual health centers. The ability to track, through the UDS system, a wide variety of information, including patient demographics, services provided, staffing, clinical indicators, utilization rates, costs, and revenues would be invaluable in improving the overall VA healthcare system;
  9. Collaborate with HHS (Health & Human Services) to allow veterans to utilize the existing system of Federally Qualified Health Centers (FQHC):
    1. FQHCs include all organizations receiving grants under section 330 of the Public Health Service Act, certain tribal organizations, and they qualify for enhanced reimbursement from Medicare and Medicaid, as well as other benefits.
    2. FQHCs are required to serve an underserved area or population; offer a sliding fee scale; provide comprehensive services; have an ongoing quality assurance program; and have a governing board of directors
    3. Rather than going unseen or untreated due to limited appointment or physician availability, veterans could seek immediate care on a temporary basis until the VA appointment backlog is eliminated;
  10. Exercise the option to terminate non-performing employees at all levels of the organization so that only dedicated, accurate, motivated employees will remain in service to our veterans; and
  11. Reform incentive programs so that only high-performing employees receive appropriate bonuses for their excellence in serving our veterans
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2 thoughts on “Fix the VA

  1. It’s about time! I personally have experienced long wait times, up to 90 days, just to see my primary care dr. That is just not acceptable by anyone, especially veterans.

  2. Thanks fr your efforts on the healthcare problems, but please don’t forget that the VBA is also broken – this healthcare issue is washing out any problems getting the benefits we deserve in a timely manner. I’ve been on HOLD with a VBA claim process since 2010-12-27!

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