Inquiry finds VA distorted wait times for vets' treatments

WASHINGTON — The VA overstated to Congress how quickly it cares for veterans, understates how many are waiting for care and may be "gaming" its own system to show better results, according to an internal investigation.

The review by the VA inspector general's office, released Monday, examined 700 outpatient appointments for primary and specialty care scheduled in October 2006 at 10 VA medical centers.

Three-fourths of veterans were seen within the required 30 days, far fewer than the 95 percent claimed by the Department of Veterans Affairs.

Of the veterans kept waiting more than 30 days, 27 percent had more serious service-connected disabilities, such as amputees and those with chronic problems including frequent panic attacks. Under Veterans Health Administration (VHA) policy, such patients must be scheduled within 30 days of their desired appointment date.

Waiting lists

In addition, despite warnings by the inspector general in 2005 to more accurately report wait times, department officials last year also may have understated the number of veterans on their electronic waiting lists by more than 53,000.

"While waiting time inaccuracies and omissions from electronic waiting lists can be caused by a lack of training and data-entry errors, we also found that schedulers at some facilities were interpreting the guidance from their managers to reduce waiting times as instruction to never put patients on the electronic waiting list," VA investigators wrote.

"This seems to have resulted in some 'gaming' of the scheduling process," the 34-page report said.

VA undersecretary for health Michael Kussman partly agreed that the agency should take additional steps to improve scheduling with better training, procedures and accounting of records. But he insisted the VA, in most cases, was doing the best it could and challenged the report's methodology, citing patient-satisfaction surveys showing roughly 85 percent of veterans getting appointments when they needed them.

"This is simply not acceptable," said Sen. Daniel Akaka, D-Hawaii, who chairs the Senate Veterans Affairs Committee. He said the report showed the VA was "skewing" its performance on veterans' health care and that the VA was not taking responsibility.

Testimony in Congress

In April, Kussman testified to Congress that 95 percent of veterans were receiving the timely appointments. The VA's 2006 annual report, issued last November, makes similar claims.

"To obtain a more objective, professional analysis of all components of VHA's scheduling process, including electronic wait lists and waiting times reporting, I plan to obtain the services of a contractor who will thoroughly assess the factors," Kussman wrote in Monday's report.

The report comes amid intense political and public scrutiny of the VA and Pentagon following reports of shoddy outpatient care of injured troops and veterans at Walter Reed Army Medical Center and elsewhere.

In recent weeks, injured Iraq war veterans have sued the VA, alleging undue delays in health care. The department also is struggling to reduce a severe backlog of disability payments, with delays of up to 177 days to process an initial claim, and it awaits a new leader to make changes once outgoing VA secretary Jim Nicholson steps down Oct. 1.

The VA medical facilities reviewed in the inspector general's report were for both primary and specialty care in Birmingham, Ala.; Atlanta; Columbia, S.C.; San Antonio, Temple and Dallas in Texas; Cincinnati; Detroit; Indianapolis; and Chillicothe, Ohio.