Audit of Veteran Wait Time Data, Choice Access, and Consult Management in VISN 6

We evaluated whether Veterans Integrated Service Network (VISN) 6 provided new veterans timely access to health care within its medical facilities and through Choice, as well as to determine whether VISN 6 appropriately managed consults. VISN 6 did not consistently have timely access to health care for new patients at its VA medical facilities and through Choice. Wait times were significantly higher than the wait time data that VHA’s electronic scheduling system showed. This occurred because VISN 6 and medical facility management did not ensure staff consistently implemented VHA’s scheduling requirements. Inaccurate wait time data resulted in a significant number of veterans not being eligible for treatment through Choice. With respect to those veterans in VISN 6 who received their care through Choice, we estimated that 82 percent of the appointments during the relevant time period had wait times longer than 30 days. This occurred primarily because medical facilities did not ensure they had sufficient staffing resources to provide timely access to Choice care. VISN 6 also did not consistently manage the timeliness of specialty care consults. We concluded that VHA and VISN 6 leadership relied on wait time data that did not accurately represent how long veterans were waiting for care. Access to health care has been a recurring issue in VHA. This audit demonstrates that many of the same access to care conditions reported over the last decade continued to exist within VISN 6 medical facilities in 2016. OIG made 10 recommendations regarding monitoring controls over scheduling requirements, wait time data, Choice, and consult management. The then-Under Secretary for Health concurred with four recommendations and concurred in principle with six recommendations. VHA’s planned corrective actions are acceptable and we will monitor VHA’s progress until all proposed actions are completed.