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VA health care wait times drop as payments to private providers rise

Dayton VA campus
Jerry Kenney
Dayton VA campus

A report indicates improved services for veterans through the Veterans Health Administration, and highlights dramatic rise in payments for outside services.

Veterans Health Administration payments to private and community health care providers rose significantly in recent years — from $7.9 billion in 2014 to $18.5 billion in 2021, according to a report.

The nonprofit research firm RAND Corp. report indicates that a major shift has taken place regarding services as wait times for outpatient specialty care at Veterans Administration facilities declined. This can make the VA a better option for veterans seeking care.

For more on this, we spoke with Dayton Daily News Reporter Thomas Gnau, who recently wrote about the Rand report.

Thomas Gnau: It looks like the VA wanted to find out if private community care has been helping veterans. And this is nothing new, the VA has been relying on private care to supplement its care for decades, all the way back to World War I and beyond. This most recent study, which was released, I think less than two weeks ago, did find that there are some differences, not dramatic differences, but essentially community care, private care wait times, are at least in some instances, longer than VA care wait times. It also found that VA providers can control their costs, in some instances, a bit better than private providers. But the differences really aren't that dramatic. This is important because the VA, especially in the last decade or so, has been hammered pretty hard for not being as responsive to some patient’s needs. And there's been some criticism of the cost of VA care as well, and this study, it seems to put all of that in perspective.

Jerry Kenney: Tom, you mentioned the challenges that the Veterans Health Administration and the Dayton VA have faced in the past with regard to services provided to their veterans and long wait times. So clearly, if this report is to be believed, then the VA has made great strides to overcome those challenges, correct?

Gnau: Yes. The VA has done a lot nationally and regionally, and Congress has done a lot. In 2014 and 2018, Congress passed a couple of milestone pieces of legislation that pointedly supplemented VA care with private community care. So, if veterans meet certain eligibility criteria, they can get private care and have that care paid for by federal taxpayers, by the VA. The idea behind that legislation is that private care may be faster or may be less expensive. And what's interesting about this study is that it found, well, that's not always the case.

Kenney: If the VA allowed veterans to use community health providers or private health providers for decades, then what did the 2015 Mission Act accomplish? Did it expand the allowable services that veterans could seek?

Gnau: Right. So, if veterans meet certain criteria, and VA facilities don't offer the services that a veteran needs, or if the veteran lives somewhere that wasn't close to a full-service VA facility, or if, you know, wait times locally at a VA facility are simply too long, veterans can seek out private care and just get paid for by the VA. I think here in the Dayton area they utilized that resource quite a bit. In my story, I reported that this year the Dayton VA is going to be able to spend about $135 million on private health care just in the Dayton area. It can a make a real difference for local talent.

Kenney: Tom, you spoke with Dayton VA Director Mark Murdoch. What does he hope will come out of this report from the RAND Institute?

Gnau: Mark is very clear that veterans are the priority. Taking care of them is a priority, and he will use whatever tool is available to help achieve that goal at the VA. They're doing a lot. My impression from the outside is that they're bending over backwards. Every month, they hold evening phone calls with groups of veterans to answer questions and to see how they're doing, to address veterans’ concerns — big matters and small matters. Veterans can ask about routine things like getting a script filled, veterans can ask about why they're not eligible for certain care or what their options are if they are eligible. That is a routine monthly way that the VA uses to stay in touch with local veterans to find out what they're thinking and what they need. So, they are using that resource.

Kenney: Thomas Gnau is a reporter with a Dayton Daily News. Tom, thanks for your time and your reporting efforts on this.

Gnau: Thank you for having me on. I appreciate it.

Jerry began volunteering at WYSO in 1991 and hosting Sunday night's Alpha Rhythms in 1992. He joined the YSO staff in 2007 as Morning Edition Host, then All Things Considered. He's hosted Sunday morning's WYSO Weekend since 2008 and produced several radio dramas and specials. In 2009 Jerry received the Best Feature award from Public Radio News Directors Inc., and was named the 2023 winner of the Ohio Associated Press Media Editors Best Anchor/News Host award. His current, heart-felt projects include the occasional series Bulletin Board Diaries, which focuses on local, old-school advertisers and small business owners. He has also returned as the co-host Alpha Rhythms.