MISSION Act Market Assessments Contain Inaccurate Specialty Care Workload Data

The VA Office of Inspector General (OIG) audited the accuracy of data used to measure VA’s capacity to provide specialty health care to veterans. The data will be used to identify gaps in care and implement recommendations for modernizing or realigning VA facilities to fill those gaps, as required by the VA MISSION Act of 2018. Using data from interviews with over 1,800 officials, the Veterans Health Administration (VHA) Office of Strategic Planning and Analysis assessed the capacity to provide health care in each of VA’s 96 geographic market areas. The OIG looked for areas where the risk of materially inaccurate data was highest and focused its audit on the accuracy of three specialty care data components: workload, wait times, and provider clinical time allocations. The OIG concluded that only the workload data inaccuracies were significant enough to affect management decisions. The OIG estimated VHA’s reported fiscal year 2019 workload for 12 specialties across all care providers was overstated by 10.7 percent, which amounts to about 563 full-time equivalent physician positions based on the average workload. This overstatement of workload could result in an inefficient use of taxpayer dollars and diminish access to care for veterans if it leads VA officials to not place staffing resources where they are needed. Without a clear understanding of the work performed, VHA cannot be sure management decisions are based on verifiable, documented services provided that will result in the most efficient allocation of taxpayer funds. The OIG recommended that the acting under secretary for health perform additional analyses to ensure materially accurate specialty care workload data are used to implement recommendations from the Asset and Infrastructure Review Commission.