Concerns with Consistency and Transparency in the Calculation and Disclosure of Patient Wait Time Data

In June 2021, a complainant alleged that the then acting principal deputy under secretary for health had been informed in the fall of 2019 that VHA’s patient wait times reporting may be misleading but that no action was taken in response. After an initial examination, the OIG determined that there was no basis to proceed with a misconduct investigation of the then acting principal deputy under secretary for health, as the OIG found no evidence of intent or efforts to mislead. This management advisory memo, however, details how VHA has presented wait times to the public without clearly and consistently disclosing the basis for their calculations. Since 2014, VHA has employed several different methodologies (particularly using different start dates) for calculating wait times reported online, as well as for determining whether wait time criteria are met for community care program eligibility. The methodologies deviated in some instances from VHA’s scheduling directive and its stated wait time measures announced in the Federal Register in 2014. As a result, VHA has presented wait times with different methodologies, using inconsistent start dates that affect the overall calculations without clearly and accurately presenting that information to the public. The OIG found that efforts to improve wait time disclosures had been under consideration but had been deferred by urgent priorities, including the COVID-19 pandemic. VHA’s efforts to improve the accuracy in its reporting of the timeliness of veterans’ access to care are dependent on the consistency of its calculations of wait times and its transparency regarding which methodologies and data sources have been used, together with any limitations. This memo serves to alert VA of the problems identified regarding wait time calculations and reporting, and requests that VA inform the OIG what action is taken to address the identified issues.