The United States Department of Veterans Affairs (VA)
is a cabinet-level agency which provides veterans with medical care
and benefits in additional to administering national cemeteries.
Currently, the Veterans Health Administration (VHA) operates over
1233 health care facilities including 168 medical centers and 1053
outpatient clinics. Nearly nine million veterans receive care through
the VHA annually. The VHA is organized regionally into 18 Veterans
Integrated Service Networks (VISN). VHA medical centers can be found
in metropolitan areas and provide both in- and out-patient services
such as surgery, critical care, mental health, orthopedics, and physical
therapy. Some medical centers also offer more advanced care such
as plastic surgery and organ transplantation.
In 2013, a Cable News Network
(CNN) investigation revealed long wait times for appointments at some
VHA medical centers and attributed some deaths to those delays. Subsequently,
other media and government investigations found that some VHA medical
facilities were not in compliance with VHA scheduling policies and
procedures and that scheduling information was being altered to show
better performance than was actually occurring. In August 2014, President
Obama signed a $16 billion bill to build more VHA facilities and to
hire more health care providers. Disciplinary actions, including
the firing of the Secretary of Veterans Affairs, were taken to address
mismanagement within the VA health care system. Despite these actions,
the problem of long wait times for medical care at veterans’
facilities continues.
In this case study we
examine changes in the appointment backlogs at VHA medical centers
from the Mid-Atlantic (VISN 6), Southeast (VISN 7), and Sunshine (VISN
8) Health Care Networks.