Access to Care roundtable: Experts identify improvement opportunities


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Access to care is about more than wait times. That was the consensus among participants of the Strategic Access Management Initiative Roundtable.

VHA’s Office of Veterans Access to Care met with health care experts, corporations, other health care organizations and academic institutions to discuss the need for national ‘access to care’ definitions and standards to be used across the U.S. health care industry.

“Access to care is a very important and complex subject,” said Kenneth W. Kizer, M.D., chief health care transformation officer and senior executive vice president for Atlas Research, LLC, and former VHA under secretary for health. “At present, there is no standard approach to or framework for defining and assessing it, making it almost impossible to compare the quality of access across health systems.

“The outcome of this roundtable affirms that access to care should be defined by more than wait times, including especially how patients feel about the timeliness of their care.”

Roundtable participants agreed that wait times are one component of assessing access. It also discussed metrics that shift the focus to coordination and continuity of care, quality of care, patients’ feeling that they were treated with compassion, and whether their individual needs were met in a timely manner.

The roundtable discussion began with an historical overview of access, including a discussion of the many ways that access to care has been defined and measured. Participants identified patient experiences and how patients feel about the care they received as the emerging way forward in high performing health systems.

“This was a great first step to secure feedback about our approach while learning more about how the private sector tracks and measures access – and that access often means different things to different healthcare organizations,” said Susan Kirsh, M.D.,VA’s  acting assistant deputy under secretary for health for access, VHA’s Office of Veterans Access to Care.

Choosing VA

Veterans are choosing VA more than ever, with nearly 60 million appointments completed in fiscal year 2019, 1.7 million more than the prior year.

“It’s fair to say that VHA is a leader in assuring timely access to care through a coordinated combination of virtual and in-person care utilizing telehealth and face-to-face visits, including visits with providers from just about anywhere using a connected device,” said Kirsh.

“VA has advantages in healthcare delivery over other health care institutions,” said Dr. Thomas H. Lee, chief medical officer for Press Ganey, Inc. “VA is in a position to focus on those segments and change the discussion on what access to care truly means.”

VA calculates wait time averages from past Veteran appointments – the primary and often sole measure used to evaluate whether VA offers Veterans access to care. Unlike most health care organizations in the private sector, VA makes its wait times available online at https://accesstocare.va.gov, as well as information about quality and patient satisfaction. Veterans, their family members and caregivers can use this information when making decisions about their care.

“Wait times must be understood in a much broader context of services provided to Veterans,” said Dr. Patrick Romano, professor of internal medicine and pediatrics at the University of California, Davis. “There are opportunities for VA and other health care institutions to better align wait times by including virtual visits and other care options.”


Rick Fox is the director of communications at VHA’s Office of Veterans Access to Care

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Comments

  1. Cynthia S    

    some of the answers the ADMIN/POLITICIANS come up with doesn’t get followed through with! I waited 3 mos for a dental procedure, my dentist got sick and had to cancel the 1st in a series of 4 appts so now I have to wait more than 3 more months. So they say “we can send you to ‘Community Care” 3 weeks later no one had contacted me, so I went to the clinic and asked… only to be told I can only use a limited list (3) because the other dentists on list won’t take more patients because the VA isn’t PAYING them!! So that makes me feel VERY comfortable with the dentist they do have… maybe they are so desperate and not quality drs!

  2. Pamela King-Smith    

    How were you able to post your questions. I’ve tried several times to no avail

  3. Pamela King-Smith    

    Please address Veterans issues with Predatory Lending practices where Veterans homes are being sold from under then illegally. Especially with the Lender/Servicer NationStar d/b/a Mr Cooper. At least 7 Veterans and myself are victims of this heinous and egregious behavior where no one is regulating their actions or lending practices. I contemplated suicide because if this atrocity. I worked so hard to finally get my own home. However, between one percentage to an increase of 100% due major health issues I feel on hard times. I worked with a Certified government listed HUD Agency, walking be through the whole process and NationStar dba Mr Cooper still Wrongfully Foreclosure and sold my home. The HUD National Counseling Agency wrote and submitted a sworn Affividat as to the process that were taken. They still illegally foreclosed and sold my home. There’s had been no one so far that will address this issue. So I ask, “what does s Veteran do at this point? Who addresses check and balances of predatory lenders practices and behaviors. Will it take someone losing their life before it is address? Who is helping us….where do we go for help? Attorney General Office, State Bar Pro Bono Advocate for Veterans, Consumer Protection, GA Legal Aid, Congressman Office, Governor, Non-profits that say they help Veterans with legal issues? RAN INTO A BRICK WALL WITH THEM ALL. Everyone one of them either said no they didn’t take these kind if cases or not taking anymore cases our we don’t deal with that at all….or never call back at all. So if someone….anyone can direct me into the right direction to get assistance with this issue I would be ever so grateful. Thank you so much. In justice, peace and integrity.

  4. Patricia Babcock    

    Dear Leadership, what are you doing to reach the older veterans? Especially the older veteran who is hours from a VA facility. Heck, I lived less than 20 minutes from CBO Clinic for at least ten years before I knew it was there. Technology, “find info at VA.gov”, is not the answer for older or rural veterans. And you can bet if the veteran doesn’t know what amazing things VA can/could do medically and financially, the spouse likely knows less. Shame on VA for not using the media types that reach ALL veterans, TV and Radio.

  5. Eddie R Cox    

    As a Vietnam vet, I believe that the staff, especially the primary doctors the vet is assigned to needs to change their attitude!!!
    They should have the attitude….”I will find a solution to your issue”….instead of “that is not the way it works at the VA”.
    I have to take “XARALTO” for the rest of my life, because I have had open heart surgery …five stents inserted in my heart and just recently spent time in the hospital for very low heat rate and low blood pressure due to AFIB…. And I have no prescriptions left to order from when this one bottle runs out. I have sent a “Secure Message ” to my primary care doctor, but all I get is the run around. She says that must be handled TMA. I have no idea who that is or how to contact them. This is nothing more than the VA run around.

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