VA Secretary Pushes More Provider Productivity as One Solution
VA Secretary Denis McDonough, right, visited Tampa and Jacksonville in Florida in mid-October after two devastating hurricanes – Milton closely following Helene. He has faced another storm over budget shortfalls related to accelerating the PACT Act. Photo from the VA Secretary’s X account
WASHINGTON, DC — Before going on recess through mid-November, Congress passed a continuing resolution to keep the federal government funded through Dec. 20, 2024. That resolution, however, did not address the $12 billion shortfall in VHA’s FY 2025 budget, which first came to light in July.
Without that money, VA will not be able to hire the estimated 5,000 additional staff the department needs to provide services to the 747,000 veterans who have enrolled in VA healthcare since the PACT Act was implemented in August 2022, expanding eligibility for potentially millions of veterans who experienced toxic exposure during their service.
Despite the shortfall, VA is continuing with its accelerated outreach efforts to bring as many eligible veterans into VA care as possible. The effort makes good on VA Secretary Denis McDonough’s promise that, whatever the budgetary outcome, he will not direct the department to scale back outreach.
“President [Joe] Biden and Secretary McDonough gave us a mandate on day one, reach out to every single veteran and every survivor who is newly eligible for care and benefits and make sure they get what they earned,” declared VA Assistant Secretary for Public and Intergovernmental Affairs Adam Farina at a recent press conference. “Since then, we’ve embarked on the largest outreach campaign in VA history.”
Since March 5, when Biden directed VA to accelerate the PACT Act timeline, opening up benefits and care to all toxic-exposed veterans, the department has increased its focus on veterans who have had no contact with VA since their military service. VA began implementing a text and email campaign beginning with Vietnam-era veterans before moving on to Gulf War veterans. As of September, VA was finishing its text campaign to Afghanistan veterans and planned to move on to Iraq veterans.
“This is the result of data we have collected over the years as well as some data we have securely purchased, which we manage securely in our systems,” Farina explained. “What that has allowed us to do is get the most up-to-date information about veterans who deployed to those conflicts and served in those places but had not yet come to us for healthcare or benefits.”
This is in addition to TV and digital media ads and thousands of VA-hosted events held across the country.
The question now is whether new veterans brought in through this outreach effort will place more strain on VA and its providers between now and when Congress can address the $12 billion shortfall. In recent months, VHA leaders have focused on increasing productivity of existing clinical staff as a way to stretch existing resources. This includes offering night and weekend clinics, and increasing the number of patients each provider sees in a day.
“I want our providers to understand that we’re looking at productivity because of the intensity of the situation we find ourselves in. It’s not meant to be a characterization of them or their performance,” McDonough explained at the press conference.
Going on to describe meeting a VA radiologist in El Paso, TX, he said, “I thought it was pretty early, right? I met him at like 7:30 a.m., and he had already been in the clinic providing radiology services since like 0600 that morning. And they were out providing radiology services in the evenings. So that’s emblematic of providers throughout the system.”
Those efforts to increase productivity have been key in reducing wait times across the system and in garnering VA some of the highest trust scores the department has ever experienced, McDonough said.
“But we’re asking for additional funds for a reason, and [I’m] hopeful we can get this resolved by the end of the year,” he said.
As for how contingent VA’s ability to keep providing this level of care is on Congress providing a timely budget that includes the additional $12 billion, McDonough wouldn’t commit. He say VA will be keeping a close eye on workload, staff levels and the budget through the end of the year.
“Those numbers are going to be constantly updated … especially with the end of the [FY 2024] fiscal year. We’ll have some accounting to do over the course of the next several weeks. So we’ll take a hard look at that.”