Personalized Healthcare Earning High Marks from Veterans

By Robert A. Petzel, MD, Under Secretary for Health, Department of Veterans Affairs

The results of the 2013 American Customer Satisfaction Index (ACSI) are in, and they show that veterans using the VA healthcare system are highly satisfied with the quality of their care and the relationships they have with their clinical providers.

In nearly all of the categories measured in this leading customer satisfaction survey, the ratings for VA healthcare met or exceeded those for private-sector healthcare. The overall ACSI satisfaction index for VA was 84 for inpatient care and 82 for outpatient care on a 100-point scale, which compares favorably with the healthcare industry scores of 80 for inpatient care and 83 for outpatient care.

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This is the fifth year in a row that VA scores in the ACSI have demonstrated superior patient satisfaction. The ratings clearly show that VA’s personalized, proactive, patient-driven approach to delivering healthcare is having a positive impact on the experiences veterans are having at our 1,700 sites of care nationwide. We are transitioning to a healthcare system focused on veterans’ personal health goals, and the shift appears to be resonating with our patients.

Veterans who use our system experience primary care much differently today than they did five years ago. Every patient in the VA healthcare system is assigned a patient-aligned care team (PACT) that they can count on to help coordinate and personalize their care. Every PACT team includes a primary care provider, clinical pharmacist, registered nurse care manager, licensed practical nurse or medical assistant and clerk.

Patients can expect their team to help them access the services they need, including the latest e-health technologies, to optimize their health and well-being. Over the past two years, VA has made that possible by expanding primary care program staffing and setting standards for PACT teams at all VA medical centers. Since the implementation of PACT, access to primary care has improved, and the number of encounters with patients has increased by 50 percent, mostly due to telephone, secure messaging, and group encounters. That translates to more veterans getting more healthcare services.

The 2013 ACSI report assessed the satisfaction of veterans who had recently been patients of the Veterans Health Administration’s inpatient and outpatient services. ACSI is the nation’s only independent, cross-industry measure of customer satisfaction, providing benchmarking between the public and private sectors. Participating in the ACSI allows us to evaluate patient perceptions of the care we provide and gives us valuable insights into how VA healthcare measures up with private-sector healthcare.

Survey participants are asked for their feedback on customer expectations, perceived value and quality, responsiveness to customer complaints and customer loyalty.  One of the most striking features in the results for 2013 is the continuing high degree of loyalty veterans have to the VA healthcare system, rated at 93%. This score has remained the same for five of the last six years, which is undoubtedly a reflection of the pride veterans have in their country’s investment in a separate healthcare system for them, devoted to understanding and meeting their unique needs.


Veterans in the survey strongly endorsed the care itself, with 91% offering positive assessments of inpatient care and 92% for outpatient care. When asked if they would use a VA medical center the next time they needed inpatient or outpatient care, veterans overwhelming indicated they would, with 96% responding favorably for inpatient care and % responding favorably for outpatient care.

Veterans also responded positively to questions related to customer service, with a 92% favorable rating for inpatient care and 91% for outpatient care. Medical providers and appointment personnel were considered highly courteous, with scores of 92 and 91, respectively. Additionally, medical providers ranked high in professionalism, with a 90% positive rating.

While the survey results show us what we’re doing right, they also reveal areas that need more attention. The recent ACSI results identify several areas for improvement, including enhancing the clarity of the information we provide our patients — in particular how we explain test results — and the accessibility of VA medical centers. We will use this invaluable feedback to guide us as we strive to make improvements in these areas.

With more than 8 million veterans enrolled, VA operates the largest integrated healthcare delivery system in the country. Last year, we provided nearly 90 million outpatient visits, and our system handles 236,000 healthcare appointments each day.

In a healthcare system that large and complex, the work to improve and enhance the care we provide our patients is never done. But as the 2013 ACSI survey results suggest, we are on track to achieving our goal of becoming a patient-centered system dedicated to providing the best possible healthcare to veterans. This nation’s veterans deserve nothing less.

Comments (1)

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  1. Martin Weiss says:

    When I see discussions of surveys, there are several questions I ask myself, for example:

    1. was the sample of veterans who used the VA system acquired in the same way as the sample of people who used non VA facilities?

    2. were the questions in the two surveys the same questions

    3. what was the methodology of the survey; its is well known that self selected samples are different from random ones

    4. was the company who did the survey of VA patients the same as the company who did the other surveys

    5. if the company who did the survey of VA patients was hired by the VA, what measures were taken to make sure the company was not influenced to report good results to increase the chance they would be hired in the future

    6. if the VA conducted the survey themselves, what measures were taken to avoid reporting bias both overt and subtle

    7. how did the VA adjust the survey to account of the possibility that some patients answered positively partly because they were grateful to be treated and wanted to make sure they would be treated in the future or were grateful to be treated at low (or no) cost to themselves

    8. what was the average cost per patient in VA as opposed to the average cost per patient outside of VA

    without knowing the answers to these questions it is difficult to accept the reported results at face value

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