Home News VA makes little headway in fight to shorten waits for care

VA makes little headway in fight to shorten waits for care

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Veterans Affair Photo
(Matt York/The Associated Press)

By David B. Caruso, The Associated Press9:51 a.m. EDT April 9, 2015

FAYETTEVILLE, N.C. — A year after Americans recoiled at new revelations that sick veterans were getting sicker while languishing on waiting lists — and months after the Department of Veterans Affairs instituted major reforms costing billions of dollars — government data show that the number of patients facing long waits at VA facilities has not dropped at all.

No one expected that the VA mess could be fixed overnight. But the Associated Press has found that since the summer, the number of vets waiting more than 30 or 60 days for non-emergency care has largely stayed flat. The number of medical appointments that take longer than 90 days to complete has nearly doubled.

Nearly 894,000 appointments completed at VA medical facilities from Aug. 1 to Feb. 28 failed to meet the health system’s timeliness goal, which calls for patients to be seen within 30 days.

A closer look reveals deep geographic disparities.

Many delay-prone facilities are clustered within a few hours’ drive of each other in a handful of Southern states, often in areas with a strong military presence, a partly rural population and patient growth that has outpaced the VA’s sluggish planning process.

Of the 75 clinics and hospitals with the highest percentage of patients waiting more than 30 days for care, 12 are in Tennessee or Kentucky, 11 are in eastern North Carolina and the Hampton Roads area of Virginia, 11 more are in Georgia and southern Alabama, and six are in north Florida.

Seven more were clustered in the region between Albuquerque, New Mexico, and Colorado Springs, Colorado.

Those 47 clinics and hospitals represent just a fraction of the more than 1,000 VA facilities nationwide, but they were responsible for more than one in five of the appointments that took longer than 60 days to complete, even though they accounted for less than 6 percent of patient visits.

That has meant big headaches for veterans like Rosie Noel, a retired Marine gunnery sergeant who was awarded the Purple Heart in Iraq after rocket shrapnel slashed open her cheek and broke her jaw.

Noel, 47, said it took 10 months for the VA to successfully schedule her for a follow-up exam and biopsy after an abnormal cervical cancer screening test in June 2013.

First, she said, her physician failed to mention she needed the exam at all. Then, her first scheduled appointment in February 2014 was postponed due to another medical provider’s “family emergency.” She said her make-up appointment at the VA hospital in Fayetteville, one of the most backed-up facilities in the country, was abruptly canceled when she was nearly two hours into the drive from her home in Sneads Ferry on the coast.

Noel said she was so enraged, she warned the caller that she had post-traumatic stress disorder, she wasn’t going to turn around — and they better have security meet her in the lobby.

Rosie Noel
Marine Corps veteran Rosie Noel displays a tattoo depicting her sons’ names and a Purple Heart that she was awarded, in her home in Sneads Ferry, N.C. After an abrupt cancellation of an already postponed appointment at the VA hospital in Fayetteville, Noel said she was enraged. “I served my country. I’m combat wounded. And to be treated like I’m nothing is unconscionable,” she said. (Photo: Patrick Semansky/AP)

“I served my country. I’m combat wounded. And to be treated like I’m nothing is unconscionable,” she said.

The AP examined wait times at 940 individual VA facilities from Sept. 1 through Feb 28 to gauge any changes since a scandal over delays and attempts to cover them up led to the resignation of VA Secretary Eric Shinseki in May and prompted lawmakers to pass the Veterans Access, Choice and Accountability Act in August. The analysis included all VA hospitals and outpatient clinics for which consistent wait time data was available. It excluded residential treatment centers, homeless dormitories and disability evaluation centers. Data for individual facilities were not available for August.

It is difficult to quantify exactly how things have changed because the VA introduced a new method for measuring wait times at the end of the summer. VA officials say the new methodology is more accurate, but its adoption also meant that about half of all patient appointments previously considered delayed are now being classified as meeting VA timeliness standards. That means published wait times now can’t be directly compared with data the VA released last spring.

The trend, however, is clear: Under the VA’s old method for calculating delays, the percentage of appointments that took longer than 30 days to complete had been steadily ticking up, from 4.2 percent in May to nearly 5 percent in September. Under the new method — the one that counts half as many appointments as delayed — the percentage went from 2.4 percent in August to 2.9 percent in February.

The number of appointments delayed by more than 90 days abruptly jumped to nearly 13,000 in January and more than 10,000 in February, compared to an average of around 5,900 the previous five months. That’s not a change that can simply be blamed on bad winter weather; many of the places reporting the largest gains are warm year-round.

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