Report Summary

Title: Audit of VHA's Mobile Medical Units
Report Number: 13-03213-152
Issue Date: 5/14/2014
City/State: Northport, NY
Clarksburg, WV
Wilmington, DE
Richmond, VA
Tuscaloosa, AL
Cincinnati, OH
Ann Arbor, MI
Jackson, MS
San Antonio, TX
Cheyenne, WY
Denver, CO
Spokane, WA
Seattle, WA
Des Moines, IA
VA Office: Veterans Health Administration (VHA)
Report Author: Office of Audits and Evaluations
Report Type: Audits, Reviews & Evaluations
Release Type: Unrestricted
Summary: At the request of the House Committee on Appropriations, the Office of Inspector General (OIG) conducted a review of VA’s use of Mobile Medical Units (MMUs) to assess whether the Veterans Health Administration (VHA) is fully utilizing MMUs to provide health care access to veterans in rural areas. We found that VHA lacks information about the operations of its MMUs and has not collected sufficient data to determine whether MMUs improved rural veterans’ health care access. VHA lacks information on the number, locations, purpose, patient workloads, and MMU operating costs. We determined VHA operated at least 47 MMUs in fiscal year 2013. Of these, 19 were funded by the Office of Rural Health (ORH) and the remaining 28 were funded by either a Veterans Integrated Service Network or medical facility. Medical facilities captured utilization and cost data in VHA’s Decision Support System (DSS) for only 6 of the estimated 47 MMUs. If VHA consistently captured these data, it could compare MMU utilization and costs with other health care delivery approaches to ensure MMUs are providing efficient health care access to veterans in rural areas. These weaknesses occurred because VHA did not designate specific program responsibility for MMU management, define a clear purpose for its MMUs, or establish policies and guidance for effective and efficient MMU operations. As a result of limited MMU data, we were unable to fully address the committee’s concerns. However, it is apparent that VHA cannot demonstrate whether the almost $29 million ORH spent, as well as unknown medical facility funding for MMUs, increased rural veterans’ health care access and the extent to which MMUs can be mobilized to support its emergency preparedness mission. We recommended the Under Secretary for Health improve the oversight of MMUs by assessing their effect on rural veterans’ health care access, establishing specific program responsibilities, policies, and guidance, including requirements to capture MMU data in DSS, and supporting emergency preparedness plans. The Under Secretary for Health concurred with our recommendations and provided an acceptable action plan. We will follow up on the implementation of the corrective actions.