VA transformation is underway, already delivering measurable results for Veterans

Secretary and Deputy Secretary update Commission on Care on state of VA


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On Monday, April 18, VA Secretary Bob McDonald and Deputy Secretary Sloan Gibson updated the Commission on Care laying out the current state of VA and the transformation that is underway to deliver better customer service and results for America’s Veterans.

In laying out the key pieces of the transformation underway – MyVA – Secretary McDonald said, “MyVA is our framework for modernizing our culture, processes and capabilities – combining functions, simplifying operations, providing Veterans a world-class, customer-focused, Veteran-centered enterprise. I know transformational change is not easy but it is our commitment to the Veterans we serve in order to bring them the customer service and the care and benefits they have earned.”

Secretary McDonald outlined the five MyVA strategies focused on customer-service excellence: improve the Veteran experience, improve the employee experience, improve internal support services, establish a culture of continuous improvement, and expand strategic partnerships. He also provided updates on progress made to date of VA’s 12 breakthrough priorities.

“We have challenges in VA and we own them, but the transformation that Bob talked about is well underway and already delivering measurable results for improving access to care and improving the Veterans experience,” said Deputy Secretary Gibson.

Deputy Secretary Gibson laid out the roadmap for VA to transform from a loose federation of regional systems to a highly integrated enterprise and integrated provider and payer model and presented the following metrics showing that transformation is underway and having positive impact on Veterans care.

  • In a nationwide, one-day Access Stand Down VHA staff reviewed the records of more than 80,000 Veterans to get those waiting for urgent care off of wait lists and into clinics. They identified just over 3,300 patients waiting for more than seven days on the electronic wait list for an appointment in a Level One clinic. By the end of the day, 80 percent were given an appointment immediately, and 83 percent were given an appointment within two-and-a-half weeks.
  • Real-time customer-satisfaction feedback collected in our medical centers through VetLink—our kiosk-based software—tells us that about 90 percent of Veterans are either “completely satisfied” or “satisfied” getting the appointment when they wanted it.
  • Annual clinical work has increased among VA providers seeing Veterans by almost 18 percent in the last three years; 20 percent when VA and non-VA providers are calculated together.
  • With changes already underway to leverage our scale and build a world class end-to-end supply chain, we have already redirected $24 million back towards activities providing better Veteran outcomes.

These results build on the elements of excellence already in place in VA’s health care system that must be maintained and, in many cases, expanded upon.

  • According to the American Customer Satisfaction Index, VA has outperformed the private sector in customer service for a decade.
  • According to a February article in the Journal of American Medicine, 30-day risk-standardized mortality rates are lower in VA than those of non-VA hospitals for acute myocardial infarction and heart failure.
  • The American Journal of Infection Control found that in five years methicillin-resistant Staphylococcus aureus (MRSA) infections declined 69 percent in VA acute care facilities and 81 percent in spinal cord injury units thanks to VA’s aggressive MRSA prevention plan.
  • The Independent Assessment found that VA performed the same or significantly better than non-VA providers on 12 of 14 effectiveness measures in the inpatient setting.
  • The Independent Assessment also found that VA performed significantly better on 16 outpatient HEDIS measures compared with commercial HMOs and significantly better on 15 outpatient HEDIS measures compared with Medicare HMOs.
  • A 2015 study found that VA mental health care was better than private-sector care by at least 30 percent on all seven performance measures, with VA patients with depression more than twice as likely as private-sector patients to get effective long-term treatment.
  • Another 2015 study found that outcomes for VA patients compared favorably to patients with non-VA health insurance, with VA patients more likely to receive recommended evidence-based treatment.

Secretary McDonald and Deputy Secretary Gibson were joined by VHA’s Assistant Deputy Under Secretary for Community Care, Dr. Baligh Yehia, who outlined the history and evolution of VA’s partnering with medical providers in the community to include the Department of Defense, Indian Health Service, several academic medical partner hospitals and a growing number of private sector providers. He outlined the path forward for the Veterans Health Administration to become an integrated payer and provider, much of which depends on a legislative proposal currently working through Congress.

VA offered demonstrations of three management tools showcasing new technology to improve the way Veterans schedule appointments and how VA health care practitioners can see and interact with patient data, all of which improve outcomes for Veterans and take into account feedback from Veterans and employees. This includes a cell phone app currently in development that will allow Veterans to schedule their own appointments as well as a program that has existed in all VA medical centers for a year-and-a-half that allows VA physicians to view a patient record that integrates information from VA, the Department of Defense and community health partners in one screen.

Today’s presentation to the Commission on Care follows a presentation less than a month ago from VA’s Under Secretary for Health, Dr. David Shulkin who laid out actions already underway at the Veterans Health Administration and the vision to move it into the future that embraces an integrated community care model.

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Comments

  1. Carl Canada    

    I am a 100% p&t and 70yrs old I live in myrtle beach Va hospital in Charleston sc. Why is it I cant use choice va for dental I was told Va does not choice Va in myrtle Beach I average 2-3 times a month visiting Charleston SC. Which is 2hrs away.

  2. Katherine Gora    

    I totally disagree, I am getting sick of the VA and not getting the care that I need period.

  3. Gary W Pelmear    

    Where in the definition of “Urgent Care” does 2 1/2 weeks appear? I called Oxnard CBOC after receiving a post card requesting me to make an appointment to see my primary provider and was told the first available appointment was September 19, 2016. I was offered Veterans Choice, but it has been my experience that They haven’t been sharing information with the VA. It’s been my experience here in California that our Veterans that I have talked with are not in the 90% that the Secretary mentions.

  4. Joseph Russo    

    My service was with the Navy from, May 26 952 to November 15 1955. l served two (2) years at
    ComServPac, Subic Bay, Phillipines. While l was there, l contacted Jaundice & Hepatitis and was
    admitted to the hospital at Clark Air Force base in Angeles, PA. l was there for three (3) months. l was told that l would always have a damaged liver. When l was discharged, no one told me l should have filed a claim. Now, at the age of 81, l finally signed up with the VA, and l am told that l have to pay for everything, because my wife and l make too much money. My wife and l make approx. $57,000.00 a year. Out of money, we pay Medicare over $2500.00, house and car insurance, over 3200.00, over
    $6600.00 for home insurance, and over #3500.00 for heat and gas. For medications and doctors visits, we pay almost $6000.00. And thats just the tip of the iceberg. My wife and l are not rich by any standards, and the VA has not changed standards of acceptance for years. l only pray that someone
    will go over the plan and make the proper adjustments. Thank you, Joe Russo

  5. steve gosnell    

    this is all great, but as a veteran awaiting over 3 years for a decision on increase for disability (PTSD), when will a increase from 50% to 100% happen.
    thank you,
    steve gosnell

  6. kenneth gierich    

    what about vets, like me and my brother that were expossed to agent orange in vietnam? after 2 years no response from the VA. and your supposed to be helping vets! BS!

  7. Penny Stillway    

    All these big wigs should try being a patient at the VA. They should try using the clinics or being hospitalized to really see what goes on and how veterans are treated. After being hospitalized in the VA, told on discharge to follow-up with clinic Doctors (most are just students, I know they need to learn but Veterans shouldn’t always be the guinea pigs)’ took so long to get a follow-up appointment that I ended back up in the hospital. This went on for over 3 months. Aides at Northport VA hospital are verbally and physically abusive. All they worry about is when they will have off.

    1. John Kittler    

      How many times over the last 30 year shave I heard of a “miraculous transformation”
      in one way or another at some government agency ?
      Penny Stillway has it right. (see above)
      Try the “undercover boss routine.
      Don’t go visit the clinics for a dog an pony show.
      Follow a Vet who has a stroke who cannot communicate well
      and gangrene in his big toe and see what happens.
      It will disgust you.
      (hint) he lost his leg…
      It will be interesting to see what the IG says.

  8. Jacqueline Wyer    

    I transitioned from private health coverage which I had for 40 years to the VA health care system in 2010. I have been part of the Minneapolis and Boston VA systems since then. This is the best health care I’ve received bar none. Far exceeds the level of care I experienced in the private sector including experience with PPO’s, EPO’s, and HMO’s during those 40 years. I only see better results in the years ahead with the continued building of these forward looking systems especially the integration of the regional systems into one integrated and cohesive system. Thank you!

  9. Donald Nichols    

    I have been receiving all of my medical and mental healthealth care from the VA in Austin Outpatient or the Temple VA Hospital in Temple, TX. Unequivocally it has been the best medical care I have received since I left the Navy in 1978. Only 1 time have I had to wait more than 15 minutes past my scheduled appointment time and then a medical assistant came out to inform me there had been an emergency. I have had only 1 issue with getting an appointment longer than 30 days and I was able to have my services provided by a private practice physician through Veteran’s choice. I think that would qualify me as at one I f the 90% mentioned in the article. Personally, I am very pleased to finally see a positive article about the progress the VA is making. While I am aware the VA Has problems and, quite honestly, there will always be problems in an organization as large as the VA, there is also a tremendous number of incredibly fantastic things happening daily throughout the VA and I most certainly want to acknowledge and thank all of the wonderful care givers throughout the Central Texas VA Health System. You guys have saved my life, physically and mentaooy, and given me hope again.

  10. THOMAS J. DIX    

    ALLOW ME TO TELL YOU WHAT THE BIGGEST PROBLEM WITH THE VA IS:

    TRYING TO FIND THE RIGHT OFFICE TO HANDLE MY PROBLEM IS THE BIGGEST PROBLEM. AFTER WAITING 29 MINUITES TO TALK TO A PERSON I GOT TRANSFERRED TO THE PHARMACY. THE VA IS SOOOOOO BIG YOU REALLY NEED PEOPLE THAT KNOW THE ORGANIZATION TO HELP A CALLER LIKE ME. OR MAYBE YOU NEED A WEB SITE THAT CAN DIRECT ME TO THE PROPER OFFICE SIMPLY BY ASKING SEVERAL QUESTIONS. I WAS RECENTLY CONNECTED TO AN OFFICE AND THE PERSON TOLD ME THAT SHE COULD NOT ANSWER THE QUESTION BECAUSE IT WAS ABOVE HERE PAY GRADE. SHE FURTHER STATED THAT SOMEONE IN WASHINGTON COULD PROBABLY FIX MY PROBLEM.

    I HAVE HEARD OF BANKS THAT ARE TOO BIG TO FAIL. BUT, THE VA IS TOO BIG TO FIND AN ANSWER TO A PROBLEM.

    PLEASE WORK ON THIS!

  11. Jim Harrim    

    Lots of smoke and mirrors in the above self serving report. Still takes 5-8 years to process a C&P claim all the way through the system including appeals. The VA sent me to a psychologist in the Choice program. She knew zero about PTSD. Her strategy was to “just make you happy and everything will be okay.” I have total hearing loss above 7Khz in my right ear and over 20 db loss in all other ranges in both ears and the VA says they will make a C&P disability award on a loss of over 26 db at 4Khz and below. Both McDonald and Gibson should resign. They have done nothing to help me.

  12. Francis Moran    

    How about compensation issues? When are those to be addressed? The ebenefits site is unreadable and unusable. DAV agents are unhelpful and totally disinterested. Updates are impossible to get. Wait times are forever. It becomes impossible to know what next move to make due to lack of information and total disinterest on the part of service organizations and the VA. If disabled vets who have served their country could only get the type of aid offered by the current regime to illegal aliens and “refugees”, we might have a shot at a reasonably comfortable life before we die. The VA seems to be the only area the current administration sees any interest in saving money. Maybe it’s need for WH vacations?

  13. Michael Blackwood    

    Can someone help me, I suffer in silence with bad horrible thoughts how to get revenge on my attackers, each and every night when it is completely dark I’m at my worst I must be alert walking armed to prepare for the attackers. The Dr tells me I have PTSD all they give me is pills to keep me calm but I don’t sleep at night I fear I will hurt someone badly can you help

    1. Judy L    

      Where are you? I can assist you

  14. Aroy Crowell    

    When any organization fails to support the veterans that allow then to live the ”good life that they live”,it’s shameful,and downright ”TREASON”!!! I have never seen a country turn it’s back on it’s veterans.

  15. Isabel Papp    

    I have been with VA Northern California-Palo Alto for more than 9 years have been quite happy until 2016. I was granted Veteran’s Choice in my community and seen twice, then all of a sudden denied and told I would have to travel more than the 30 mile distance, and even tho I have discussed with my Primary Dr. my PTSD increased stress of Excessive Travel Burden to travel to this VA facility for AN INITIAL consultation; which all 3 according to Dr. Shulkin’s new VA Veteran’s Choice Program are supposed to make transition and transparency for Veteran’s to receive care, closer to their own Community, continuity of care, and show how the VA is working with the Community & helping Veterans….well, the VAHC system is doing everything in their power to hold onto the 60 BILLION DOLLARS (probably more now) allocated for us Vets. Yes, I have contacted my Congressman and have heard nothing. I have called patient Advocates at VA, they can do nothing. Dr. Shulkin, what can you do for me?

  16. Judy L    

    This article is fluff. The VA has a LONG WAY still to go to step up to the plate for us!

  17. Patrick jahnke    

    Va 2 years ago hit the bottom of the ocean. They telling nurses to give vet what to do get meds over the counter, and he she never contact the doc in person but send him/her a note so so call about this I did this , she never offer vet see the doctor!!! 3 months I went to top made a complaint not patient advocate thier go between cover up the top 4 month I final go gall bladder gone with.. Move Iowa to Madison. Seen a doc 30 mins see uu in 6 months, that bs!!!!!! At least Choice doctor I cc once a month helps va doctors don’t have time cc veteran pass him /her on to wrong clinic , the clinic u they should cc refused to cc veteran. So don’t give bs va is doing better. Worse still worse fight to cc new doctor sooner than 4-6 months so va has alot bs clean out and don’t lie to news. It all a cover up. Full of bs

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