VA says it's seeing more patients than ever and cutting wait times for them

The Veterans Affairs Department’s concerted efforts to see patients more quickly are paying dividends, the agency announced on Friday, as it has successfully lowered wait times despite a rush of veterans newly seeking care. 

A variety of strategies to get more veterans in the door has led to new patients seeing primary care doctors 11% faster and mental health clinicians 7% more quickly in April 2024 compared to the same month last year. VA recently concluded a series of “access sprints” to reduce wait times for certain types of visits including those related to mental health, which involved increasing appointment availability through staffing efforts and opening evening and weekend clinics.

The average time from the request or identification of a need for a mental health appointment until the doctor actually sees the patient is now just 17.4 days. If the wait is more than 20 days, VA can send veterans into the private sector as part of its community care program. 

“I challenge any other health care system, frankly, to see what their wait times are compared to this,” VA Undersecretary for Health Shereef Elnahal told reporters on Friday. 

VA has focused on wait times acutely since a 2014 scandal uncovered the department had used deceptive practices to hide how long veterans were truly waiting to receive care. Multiple legislative efforts have overhauled its practices, including by significantly expanding the number of patients VA sends to the private sector on the government’s dime.  

Elnahal said the gains are sustainable even though the access sprints were only temporary. While those efforts helped bring about the improvements, he said, they wrapped up in early March and the reduced wait times have persisted. In the first five months of fiscal 2024, VA saw a 19% reduction in new patients waiting more than 20 days for a primary care appointment and a 9% reduction for those waiting that long for a mental health care appointment. 

“Many of the new appointment slots that we've been able to offer have continued, and so we're not slowing down, we're actually continuing the excellent results of the sprints,” he said. 

The Veterans Health Administration added 61,000 employees in fiscal 2023, growing its workforce by 7%. Elnahal said that hiring, in addition to productivity gains, will lead to long-term sustainability of the improved access to care. While VHA is no longer seeking to boost its workforce, and is looking to reduce headcount in many parts of the agency, the undersecretary expressed confidence his agency has the staffing it needs. 

He noted VHA is concerned about burnout as the agency sees more patients at a faster clip, but said it has taken steps to proactively address the issue. VA recently held AI tech sprints that came up with solutions that reduce burnout by eliminating rote tasks, such as automated note taking during appointments. VHA has hired chief well-being officers to ensure a “supportive work environment” for staff, allowed for more frequent breaks and is planning to pilot and scale up its new technological innovations. VA boosted its retention by 20% in fiscal 2023, in part due to new pay and bonus authorities it used for thousands of employees. 

As a result of the PACT Act, which newly made eligible for VA care veterans at risk of toxic exposure, the department brought in 400,000 new enrollees to its system in 2023. That marked a 30% increase over the previous year. New patient appointments grew by 11% in the first five months of fiscal 2024 compared to the same period the previous year. On top of that, Elnahal said, VA is seeing increased demand for its existing patients as veterans get older and develop more chronic conditions. 

Elnahal made the announcement as he is facing pressure from Congress over his role in improperly doling out bonuses to senior executives at VHA’s headquarters in Washington. A dozen Senate Republicans signed onto a letter asking Elnahal to resign, while the House Veterans Affairs Committee has called on the undersecretary to testify on the matter. Elnahal on Friday said he took responsibility for “everything that happens in VHA” and committed to implementing recommendations put forward by the department’s inspector general to ensure “this never happens again.”