April 8, 2016

Top VA health care official announces initiatives, progress made to improve access

The Department of Veterans Affairs’ top health care official announced April 8 progress and new steps VA is taking to improve Veterans access to health care.

Dr. David J. Shulkin, Under Secretary for Health, announced the measures during a briefing to a group of more than 100 journalists attending the Association of Health Care Journalists’ conference April 8 in Cleveland, Ohio.

“We are working to rebuild the trust of the American public and more importantly the trust of the Veterans whom we are proud to serve,” said Shulkin. “We are taking action and are seeing the results. We are serious about our work to improve access to health care for our nation’s veterans. We want them to know that this is a new VA.”

During the briefing, Shulkin discussed a new initiative, MyVA Access. MyVA Access represents a major shift for VA by putting veterans more in control of how they receive their health care. It is a top priority for VA’s Veterans Health Administration.

MyVA Access is a declaration from VHA employees to the veterans they care for; it is a call to action and the reaffirmation of the core mission to provide quality care to veterans, and to offer that care as soon as possible to veterans how and where they desire to receive that care. The initiative ensures that the entire VA health care system is engaged in the transformation of VA into a veteran-centered service organization, incorporating aspirational goals such as same day access to mental health and primary care services for Veterans when it is medically necessary. At present, 34 VA facilities offer same-day appointments, and as a practicing physician, Shulkin currently sees veterans needing same-day appointments at the VA Medical Center in Manhattan. The VA is hoping to be able to offer same day appointments when it is medically necessary at all of its medical centers by the end of 2016. 

In addition, Shulkin introduced a new smart phone app called the Veteran Appointment Request App. This app allows veterans to view, schedule and cancel primary care and mental health appointments as well as track the status of the appointment request and review upcoming appointments. It is currently available in 10 locations and has received positive feedback from the vast majority of Veterans using the app. VA expects to make the app available to all veterans by early 2017.

Other efforts underway include a website enhancement that will allow veterans to check wait times in real time where ever they live — this includes new and existing patients and a new, easy-to-use scheduling software program. The new program is being piloted in 10 sites and is expected to reduce scheduling errors and enhance VA’s ability to measure and track supply, demand and usage.

MyVA Access is part of MyVA, introduced in 2014 by VA Secretary Robert McDonald following one of the most challenging times in the history of VA. MyVA is centered around the needs of veterans by putting them first in everything VA does. Since that time, VA has made significant progress in addition to the new initiatives announced by Shulkin.

Among the health care progress made: 
* Nationally, VA completed more than 57.36 million appointments from March 1, 2015, through Feb. 29, 2016. This represents an increase of 1.6 million more appointments than were completed during the same time period in 2014/2015.
* VHA and Choice contractors created more than 3 million authorizations for veterans to receive care in the private sector from Feb. 1, 2015, through Jan. 31, 2016.  This represents a 12 percent increase in authorizations when compared to the same period in 2014/2015.  
* From fiscal year 2014 to fiscal 2015, Community Care appointments increased approximately 20 percent from 17.7 million in fiscal 2014 to 21.3 million in fiscal 2015.
* VA completed 96.46 percent of appointments in February 2016 within 30 days of clinically indicated or veteran’s preferred date.
* In fiscal 2015, VA activated 2.2 million square feet of space for clinical, mental health, long-term care, and associated support facilities to care for veterans.
* VA held two Access Stand Downs, focusing on patients with the most urgent health care needs first. During a nationwide Access Stand Down that took place Feb. 27, the one-day event resulted in VA reviewing the records of more than 80,000 veterans to get those waiting for urgent care off wait lists; 93 percent of veterans waiting for urgent care were contacted, with many receiving earlier appointments.
* VA increased its total clinical work (direct patient care) by 10 percent over the last two years as measured by private sector standards (relative value units). This increase translates to roughly 20 million additional provider hours of care for our veterans.
* VA is also working to increase clinical staff, add space and locations in areas where demand is increasing and extending clinic hours into nights and weekends, all of which have helped increase access to care even as demand for services increases.
* VA is addressing critical components necessary for the delivery of a seamless community care experience by consolidating all purchased care programs into one Veterans Choice Program (New VCP). The New VCP will clarify eligibility requirements, strengthen VA’s high-performing network, streamline clinical and administrative processes, and implement a care coordination model across the continuum of care.
* VHA offers an extensive community provider network of over 257,000 providers through the PC3/Choice Programs and more are joining each month.
* VA Telehealth services are critical to expanding access to VA care in more than 45 clinical areas.
* In fiscal 2015, 12 percent of all veterans enrolled for VA care received Telehealth based care. This includes 2.14 million telehealth visits, touching 677,000 veterans.

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