Study questions VA health care

The department seems to have oversold its achievements within its medical system.
By CHRIS ADAMS
McClatchy Newspapers
WASHINGTON James Nicholson, secretary of the Department of Veterans Affairs, told Congress in February about the VA’s “exceptional performance” in getting veterans to see doctors.
In 2006, the VA said 95 percent of its appointments “occurred within 30 days of the patient’s desired date.” In previous years, Nicholson and other VA officials have touted the department’s record on this issue.
Evidence from the VA itself indicates that the record might be inflated.
According to a 2005 report from the agency’s inspector general, VA schedulers routinely put the wrong requested appointment dates into the system, often making waiting times appear to evaporate. In many cases, the scheduler checked for the next available time slot and declared it the patient’s “desired date.”
On Oct. 2, 2003, a veteran was referred to an ophthalmology clinic. On May 3, 2004, a scheduler created an appointment, saying that the “desired date” was June 21. The appointment was scheduled for June 23, the inspector general said.
Actual waiting time: 264 days. Reported waiting time: two days.
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WASHINGTON The VA has habitually exaggerated the record of its medical system, inflating its achievements in ways that make it appear more successful than it is, a McClatchy Newspapers study shows.
Although the Department of Veterans Affairs’ health system has gotten good marks for a transformation it has undertaken over the past decade, the department also has a habit of overselling its progress in ways that assure Congress and others that the agency has enough resources to care for the nation’s soldiers.
The assurances have come at a difficult time for the agency, as a surge in mental health ailments among returning veterans over the last few years has strained the system and a spate of high-profile problems with caring for veterans in the VA and the Department of Defense’s Walter Reed Army Medical Center has provoked heightened public scrutiny.
A review by McClatchy Newspapers of the quality measures the VA itself commonly cites found:
•The agency has touted how quickly veterans get in for appointments, but its own inspector general found that scheduling records have been manipulated repeatedly.
•The VA boasted that its customer service ratings were 10 points higher than those of private-sector hospitals, but the survey it cited showed a far smaller gap.
•Top officials repeatedly have said that a pivotal health quality study ranked the agency’s health care “higher than any other health-care system in this country.” However, the study they cited wasn’t designed to do that.
In general, the VA highlighted what it said were superior conditions in its health system. Over the past 10 years, the agency remade itself, boosting outpatient and preventive care in a growing network of outpatient clinics. It has received glowing news coverage for the transformation.
“Today we’re positioned as an internationally respected force in health-care delivery, leading private and government providers across every measure,” Secretary James Nicholson said in a 2005 speech. “And we can prove it.”
On key issues of access, satisfaction and quality of care, however, other data contradict the agency’s statements.
Consider the care for returning soldiers with post-traumatic stress disorder — a major ailment to emerge from the war in Iraq.
The VA’s top health official, Michael Kussman, was asked in March about the agency’s resources. He said the VA had boosted stress-disorder treatment teams in its facilities.
“There are over 200 of them,” he told a congressional subcommittee. He indicated that they were in all of the agency’s approximately 155 hospitals.
When McClatchy asked for more detail, the VA said that about 40 hospitals didn’t have the specialized units. Committees in the House and the Senate and experts within the VA have encouraged the agency to put those teams into every hospital.
About 30 hospitals have neither stress-disorder teams nor any other specialized disorder programs, although all hospitals have at least one person who specializes in the ailment, VA records show.
The VA stood by Kussman’s statement. He wasn’t referring to a specific type of team, officials at the agency said, but to the fact that a collection of medical professionals will tend every veteran, whether or not his or her hospital has a stress-disorder clinical team.
Lengthy wait to see doctor WASHINGTON James Nicholson, secretary of the Department of Veterans Affairs, told Congress in February about the VA’s “exceptional performance” in getting veterans to see doctors.
In 2006, the VA said 95 percent of its appointments “occurred within 30 days of the patient’s desired date.” In previous years, Nicholson and other VA officials have touted the department’s record on this issue.
Evidence from the VA itself indicates that the record might be inflated.
According to a 2005 report from the agency’s inspector general, VA schedulers routinely put the wrong requested appointment dates into the system, often making waiting times appear to evaporate. In many cases, the scheduler checked for the next available time slot and declared it the patient’s “desired date.”
On Oct. 2, 2003, a veteran was referred to an ophthalmology clinic. On May 3, 2004, a scheduler created an appointment, saying that the “desired date” was June 21. The appointment was scheduled for June 23, the inspector general said.
Actual waiting time: 264 days. Reported waiting time: two days....
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