Better oversight is needed to address problems with servicemember healthcare, says GAO


Poor oversight, sporadic case management and inconsistent criteria are preventing military servicemembers and veterans from getting the medical help and disability treatment they need as they transition between Defense and Veteran Affairs programs, says the Government Accountability Office.

In a Nov. 16 report (.pdf), GAO says that VA and DoD veteran and disability programs are often inaccessible to those who need them because of inconsistent standards and case management, including varying eligibility and disability criteria in the services' wounded warrior programs.

While the departments jointly developed "an integrated disability evaluation system to expedite the delivery of benefits to servicemembers," the processing times for disability determinations have consistently increased under the new system, says the report. Since 2008, delays have grown by more than 110 days for active duty servicemember cases, and by more than 120 days for reservist cases.

The main cause arises from a collective lack of oversight and enforcement, auditors say. The Senior Oversight Committee, established to manage these combined efforts, slowly lost its way and was no longer effective by the time it merged with the VA/DoD Joint Executive Council in Jan. 2012, they add.

GAO also says that DoD and VA have yet to develop sufficient capabilities for electronic health records, which it says can delay a servicememeber's receipt of coordinated care and benefits as they move between the healthcare systems of each department.

In all of fiscal 2011, the Senior Oversight Committee met for a total of 11 hours and had most of its oversight mechanisms stripped or made ineffective by departmental changes.

While the departments' joint efforts to resolve case management gaps and care coordination problems have been largely unsuccessful, these issues are now being addressed directly by a joint task force established in May 2012. Success from this task force will hinge on the development of a mechanism for joint policy decisions and authority to implement them, says GAO.

GAO notes the departments are addressing some of these problems through new staff hires to process and share electronic health records and operate in the integrated disability evaluation process.

For more:
- download the report, GAO-13-5 (.pdf)

Related Articles:
VA shifting focus to patient-centered EHRs
IOM: No more DoD-VA integrated medical centers until iEHR
Possible healthcare savings of $385 billion require scrapping current plans, says Center for American Progress